Individual
KELSEY JORDAN ST. AMAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C, MPH
Contact information
Practice address
3181 SW SAM JACKSON PARK RD # L353, PORTLAND, OR 97239-3098
(503) 494-4190
(503) 494-7829
Mailing address
3181 SW SAM JACKSON PARK RD # L353, PORTLAND, OR 97239-3098
(661) 678-3778
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA211583
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500809282
—
OR
Enumeration date
05/13/2021
Last updated
02/09/2024
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