Individual
KELLY MA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
4540 NE GLISAN ST, PORTLAND, OR 97213-2333
(503) 215-3738
Mailing address
35 NE TILLAMOOK ST APT D, PORTLAND, OR 97212-3765
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
325237
OR
Other
Enumeration date
01/25/2021
Last updated
01/25/2021
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