Organization
KELEMENTAL HEALTH, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KELLY WITBECK DNP, APRN (OWNER)
(503) 799-8679
Entity
Organization
Contact information
Practice address
833 SW 11TH AVE STE 915, PORTLAND, OR 97205-2123
(360) 615-2780
Mailing address
833 SW 11TH AVE STE 915, PORTLAND, OR 97205-2123
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
—
—
363LF0000X
Family Nurse Practitioner
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
02/20/2023
Last updated
02/18/2024
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