Individual
KELLY C YAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Contact information
Practice address
1020 SW TAYLOR ST. SUITE 448, PORTLAND, OR 97205-2509
(971) 300-4254
(503) 200-1241
Mailing address
1020 SW TAYLOR ST. SUITE 448, PORTLAND, OR 97205-2509
(971) 300-4254
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
201809234RN
OR
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
202006258NP-PP
OR
Other
Enumeration date
02/29/2020
Last updated
06/18/2025
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