Individual
KELSEY STANG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2406 SE 60TH AVE, PORTLAND, OR 97206-1303
(503) 457-7799
Mailing address
15452 SE BUSH ST, PORTLAND, OR 97236-2249
(503) 724-7028
Taxonomy
Speciality
Code
Description
License number
State
175F00000X
Naturopath
Primary
4167
OR
Other
Enumeration date
08/22/2018
Last updated
08/22/2018
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