Individual
KELSEY SELENE PETERSON WOLFE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
25 NW 23RD PL, PORTLAND, OR 97210-5580
(503) 305-6262
Mailing address
25 NW 23RD PL, PORTLAND, OR 97210-5580
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
197994
OR
Other
Enumeration date
03/22/2017
Last updated
08/05/2020
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