Individual
MR. KELVIN ANDRE PITTMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2130 SW 5TH AVE, PORTLAND, OR 97201-4976
(503) 963-7765
Mailing address
3926 N MICHIGAN AVE, PORTLAND, OR 97227-1151
(971) 344-6843
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
—
—
Other
Enumeration date
05/21/2007
Last updated
07/08/2007
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