Individual
MEGAN SUMMER KELLISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-MSN
Contact information
Practice address
6637 SE MILWAUKIE AVE STE 202, PORTLAND, OR 97202-5658
(503) 208-3597
Mailing address
6637 SE MILWAUKIE AVE STE 202, PORTLAND, OR 97202-5658
(503) 208-3597
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
202111862NP-PP
OR
Other
Enumeration date
03/13/2022
Last updated
03/13/2022
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