Individual
WILLIAM KELLY MCBRIDE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PMHNP
Contact information
Practice address
10373 NE HANCOCK ST STE 200, PORTLAND, OR 97220-3873
(503) 253-6754
Mailing address
2121 SE BELMONT ST APT 330, PORTLAND, OR 97214-3471
(585) 755-7239
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
202210055NP-PP
OR
Other
Enumeration date
09/12/2022
Last updated
09/12/2022
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