Individual
KELSY MARIE BAKKEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
290 MOYER LN NW, SALEM, OR 97304-3822
(503) 370-8990
(503) 363-4214
Mailing address
8669 SW HOLLY ST, #110, WILSONVILLE, OR 97070-8628
(608) 445-1166
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
233451
OR
Other
Enumeration date
11/01/2007
Last updated
11/01/2007
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