Individual
DR. MARY ALLEGRA KELLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
1501 NE MEDICAL CENTER DR, BEND, OR 97701-6099
(541) 382-4900
Mailing address
PO BOX 6048, BEND, OR 97708-6048
(541) 382-4900
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
DO212875
OR
390200000X
Student in an Organized Health Care Education/Training Program
BP10067289
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500820545
—
OR
Enumeration date
06/04/2019
Last updated
09/15/2023
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