Individual
DR. KELLY MARY BALTAZAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
N.D., D.C.
Contact information
Practice address
3025 SW CORBETT AVE, PORTLAND, OR 97201-4858
(503) 552-1551
(503) 226-8133
Mailing address
7425 SW ALOMA WAY APT 1, PORTLAND, OR 97223-7919
(425) 269-8187
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
5843
OR
175F00000X
Naturopath
Primary
4063
OR
Other
Enumeration date
07/03/2007
Last updated
07/21/2022
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