Individual
MS. KELLY CLARK HILDENBRAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BSN, RN
Contact information
Practice address
3925 SE 48TH AVE, PORTLAND, OR 97206-3231
(503) 771-5602
Mailing address
3925 SE 48TH AVE, PORTLAND, OR 97206-3231
(503) 771-5602
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
OSBN 09600231RN
OR
Other
Enumeration date
10/22/2007
Last updated
10/22/2007
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