Individual
MRS. JESSICA ANN KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
8 N STATE ST, LAKE OSWEGO, OR 97034-3956
(503) 635-3483
Mailing address
16535 SE JASPER DR, DAMASCUS, OR 97089-9130
(503) 855-4337
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
H4611
OR
Other
Enumeration date
11/13/2008
Last updated
11/13/2008
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