Individual
KELLY SUSANNE BARRETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DC
Contact information
Practice address
1330 SE 39TH AVE, PORTLAND, OR 97214-4322
(503) 232-1100
(503) 232-7751
Mailing address
1933 NE 55TH AVE, PORTLAND, OR 97213-3506
(503) 493-9743
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
273123
OR
Other
Enumeration date
07/29/2006
Last updated
07/08/2007
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