Individual
NICOLE L KEHRER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1600 STATE ST, SALEM, OR 97301-4257
(503) 540-6300
(503) 540-6404
Mailing address
1600 STATE ST, SALEM, OR 97301-4257
(503) 540-6300
(503) 540-6404
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA167325
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA167325
OREGON MEDICAL LICENSE
OR
Enumeration date
04/13/2012
Last updated
06/10/2019
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