Individual
KAILIA WRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(971) 717-5670
Mailing address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(971) 717-5670
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
201907636NP-PP
OR
367A00000X
Advanced Practice Midwife
Primary
201907636NP-PP
OR
Other
Enumeration date
04/03/2018
Last updated
01/12/2021
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