Individual
DR. KELLY JENNINGS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.D., MSOM
Contact information
Practice address
4900 SE DIVISION ST, PORTLAND, OR 97206-1544
(503) 444-5977
Mailing address
4900 SE DIVISION ST, PORTLAND, OR 97206-1544
(503) 445-9771
Taxonomy
Speciality
Code
Description
License number
State
175F00000X
Naturopath
Primary
1620
OR
Other
Enumeration date
05/08/2008
Last updated
05/08/2008
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