Individual
KELLIE MITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
705 ELM ST SW STE 300, ALBANY, OR 97321
(541) 812-4580
Mailing address
PO BOX 1188, CORVALLIS, OR 97339-1188
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA188699
OR
Other
Enumeration date
09/23/2016
Last updated
11/04/2020
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