Individual
KERRY LEE O'BRIEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
4560 SE INTERNATIONAL WAY, SUITE 100, MILWAUKIE, OR 97222-4628
(503) 312-4607
(503) 296-2408
Mailing address
4560 SE INTERNATIONAL WAY, SUITE 100, MILWAUKIE, OR 97222-4628
(503) 312-4607
(503) 296-2408
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
200250084NP
OR
363LF0000X
Family Nurse Practitioner
Primary
200950006NP
OR
363LG0600X
Gerontology Nurse Practitioner
200250083NP
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000677
—
OR
05
—
1366418535
—
WA
Enumeration date
02/27/2006
Last updated
08/10/2020
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