Individual
MR. NEAL N KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
664 3RD ST, LAKE OSWEGO, OR 97034-2348
(503) 504-8554
(360) 213-2238
Mailing address
664 3RD ST, LAKE OSWEGO, OR 97034-2348
(503) 504-8554
(360) 213-2238
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH-0012232
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RPH-0012232
PHARMACIST LICENSE
OR
01
—
RPH-0012232-P
PHARMACY PRECEPTOR LICENSE
OR
Enumeration date
03/22/2013
Last updated
04/30/2013
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