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Individual

KELSEY LEIGH BUSHONG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
2628 SE 47TH AVE, PORTLAND, OR 97206-1504
(503) 964-8112
Mailing address
2628 SE 47TH AVE, PORTLAND, OR 97206-1504
(503) 964-8112

Taxonomy

Speciality
Code
Description
License number
State
133N00000X
Nutritionist
374J00000X
Doula
Primary
OR

Other

Enumeration date
06/14/2021
Last updated
06/14/2021
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