Individual
KYLE ALLEN NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MPH, ATC
Contact information
Practice address
5000 N WILLAMETTE BLVD, PORTLAND, OR 97203-5743
(503) 943-7747
(503) 943-7532
Mailing address
17705 SE 16TH ST, VANCOUVER, WA 98683-1918
(360) 891-8199
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
0821360756
OR
Other
Enumeration date
03/02/2007
Last updated
07/08/2007
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