Individual
DAVID ALLEN KELLY JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNP
Contact information
Practice address
3303 S BOND AVE, PORTLAND, OR 97239-4501
(503) 494-6346
(503) 494-5385
Mailing address
1400 SW 5TH AVE STE 500, PORTLAND, OR 97201-5537
(866) 617-6855
(503) 346-8015
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
202207583NP-PP
OR
Other
Enumeration date
01/16/2024
Last updated
05/07/2024
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