Individual
KELLEY S. FELLMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3415 SE POWELL BLVD, PORTLAND, OR 97202-3371
(503) 234-9591
Mailing address
6115 NE 30TH AVE, PORTLAND, OR 97211-6735
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
MD25861
OR
Other
Enumeration date
07/24/2006
Last updated
03/26/2009
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