Individual
KELLI BURK IRANSHAD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
25117 SW PARKWAY AVE STE D, WILSONVILLE, OR 97070-9697
(503) 570-3665
Mailing address
13692 SE GANNON DR, CLACKAMAS, OR 97015-6416
(503) 558-9077
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1024601
OR
Other
Enumeration date
06/20/2008
Last updated
06/20/2008
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