Individual
KRYSTAL KEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
IBCLC
Contact information
Practice address
9920 SE REEDWAY ST, PORTLAND, OR 97266-4356
(503) 388-1576
Mailing address
9920 SE REEDWAY ST, PORTLAND, OR 97266-4356
(503) 388-1576
Taxonomy
Speciality
Code
Description
License number
State
174N00000X
Lactation Consultant (Non-RN)
Primary
L-82170
OR
Other
Enumeration date
11/10/2015
Last updated
11/10/2015
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