Individual
ASHLEY R KELSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1003 PROVIDENCE DR STE 110, NEWBERG, OR 97132
(503) 537-5900
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA185165
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500741164
—
OR
Enumeration date
11/29/2017
Last updated
04/18/2023
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