Individual
KELLY ROBYN VINZANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4805 NE GLISAN ST, PORTLAND, OR 97213-2933
(503) 215-1111
Mailing address
2349 SE 152ND AVE, PORTLAND, OR 97233-3400
(971) 724-4634
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
200111433CNA
OR
Other
Enumeration date
03/24/2025
Last updated
03/24/2025
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