Individual
KELLI LYNN THOMSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LE
Contact information
Practice address
917 NW OVERTON ST, PORTLAND, OR 97209-3197
(503) 890-5355
Mailing address
3925 SW MULTNOMAH BLVD APT 103, PORTLAND, OR 97219-3589
(503) 890-5355
Taxonomy
Speciality
Code
Description
License number
State
171400000X
Health & Wellness Coach
Primary
COS-FT-935744
OR
Other
Enumeration date
06/03/2024
Last updated
06/03/2024
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