Individual
KELVINA CORNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
847 NE 19TH AVE, PORTLAND, OR 97232
(503) 238-0769
Mailing address
PO BOX 8459, PORTLAND, OR 97207-8459
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
10/23/2020
Last updated
01/16/2024
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