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Individual

ELAN KENNEDY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
3181 SW SAM JACKSON PARK RD., MAIL CODE L353, OHSU, DIVISION OF CARDIOTHORACIC SURGERY, PORTLAND, OR 97239
(503) 494-7820
Mailing address
3181 SW SAM JACKSON PARK RD., MAIL CODE L353, OHSU, DIVISION OF CARDIOTHORACIC SURGERY, PORTLAND, OR 97239
(503) 494-7820

Taxonomy

Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
055-0031496
VT
363AS0400X
Surgical Physician Assistant
Primary

Other

Enumeration date
12/10/2013
Last updated
04/08/2021
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