Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Nicolle Asencio

Individual provider Family Nurse Practitioner · NPI 1225753692

Nicolle Asencio is a Nurse Practitioner in Portland, Oregon. Qualified in 2024, 2 years ago. Practices with The Wallace Medical Concern, a 10-clinician group and accepts Medicare assignment. Licensed in Oregon.

Years since qualifying
2
Licensed in
OR
In the registry since
2022

Practice location Address checks out

19500 SE Stark St
Portland, OR 97233-5757
Phone: (800) 813-2000
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 10031838 (OR)

Record details

NPI number1225753692
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedOctober 7, 2022
Last updated in NPPESNovember 15, 2024
Certification dateNovember 15, 2024
Mailing address8703 N Chase Ave, Portland, OR 97217

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice The Wallace Medical Concern — 10 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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