Provider Demographics
NPI:1124286307
Name:TURNER, NICOLE RENEE (MD)
Entity type:Individual
Prefix:DR
First Name:NICOLE
Middle Name:RENEE
Last Name:TURNER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MISS
Other - First Name:NICOLE
Other - Middle Name:RENEE
Other - Last Name:STEIDLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:500 NE MULTNOMAH ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97232-2023
Mailing Address - Country:US
Mailing Address - Phone:800-813-2000
Mailing Address - Fax:855-524-5255
Practice Address - Street 1:13705 NE AIRPORT WAY STE C
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97230-1048
Practice Address - Country:US
Practice Address - Phone:800-813-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-24
Last Update Date:2025-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD157008207ZP0102X
WAMD60385990207ZP0102X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2026637Medicaid