Individual
KELLY WILLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
25117 SW PARKWAY AVE STE D, WILSONVILLE, OR 97070-9697
(971) 364-0611
(971) 364-0610
Mailing address
25117 SW PARKWAY AVE STE D, WILSONVILLE, OR 97070-9697
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
Other
Enumeration date
05/07/2022
Last updated
05/07/2022
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