Individual
MAUREEN ELIZABETH KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
8317 N HARTMAN ST, PORTLAND, OR 97203-1103
(541) 510-9612
Mailing address
8317 N HARTMAN ST, PORTLAND, OR 97203-1103
(541) 510-9612
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2247
OR
Other
Enumeration date
12/20/2005
Last updated
07/27/2011
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