Individual
KELLY WASHBURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, NP-C
Contact information
Practice address
5935 SE BELMONT ST, PORTLAND, OR 97215-1925
(860) 670-6348
Mailing address
5935 SE BELMONT ST, PORTLAND, OR 97215-1925
(971) 328-0083
(833) 502-1522
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
201503413NP-PP
OR
363L00000X
Nurse Practitioner
5118
CT
Other
Enumeration date
11/05/2012
Last updated
10/16/2021
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