Individual
KELLY JEAN CHRISTIANSEN FOSTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-8311
Mailing address
6738 SE RAMONA ST, PORTLAND, OR 97206-5963
(503) 580-1212
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
10/04/2022
Last updated
10/04/2022
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