Individual
MRS. CHAWANNUT KELLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
520 NW LOST SPRINGS TER STE 408, PORTLAND, OR 97229-6660
(334) 437-2367
Mailing address
520 NW LOST SPRINGS TER STE 408, PORTLAND, OR 97229-6660
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
H8972
OR
Other
Enumeration date
05/12/2025
Last updated
05/12/2025
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