Individual
KEYSHA RAE KENDALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1500 NE IRVING ST, SUITE 250, PORTLAND, OR 97232
(503) 233-4356
Mailing address
4528 SE ROETHE RD, APARTMENT 51, MILWAUKIE, OR 97267
(503) 686-0756
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
6560340
OR
Other
Enumeration date
08/29/2012
Last updated
08/29/2012
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