Individual
JANICE J KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP
Contact information
Practice address
1130 NW 22ND AVE, STE 640, PORTLAND, OR 97210-2993
(503) 229-7976
(503) 274-4867
Mailing address
1130 NW 22ND AVE, STE 640, PORTLAND, OR 97210-2993
(503) 229-7976
(503) 274-4867
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
000032737N3
OR
363L00000X
Nurse Practitioner
AP30002264
WA
363L00000X
Nurse Practitioner
APRN-3153
HI
Other
Enumeration date
03/14/2006
Last updated
07/02/2021
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