Individual
KELSEY MOORE MATHESON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-8311
Mailing address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA206279
OR
Other
Enumeration date
05/04/2020
Last updated
05/26/2023
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