Individual
MR. KELLY MCCORMICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BC-HIS
Contact information
Practice address
1939 E BURNSIDE ST, PORTLAND, OR 97214-1535
(503) 233-6141
(503) 233-2889
Mailing address
1939 E BURNSIDE ST, PORTLAND, OR 97214-1535
(503) 233-6141
(503) 233-2889
Taxonomy
Speciality
Code
Description
License number
State
237700000X
Hearing Instrument Specialist
HA00002483
WA
237700000X
Hearing Instrument Specialist
Primary
HAS-P-353618
OR
Other
Enumeration date
03/07/2007
Last updated
07/19/2013
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