Individual
ESJE KELLAN WOOLFE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MOTR/L
Contact information
Practice address
5200 SW MACADAM AVE STE 100, PORTLAND, OR 97239-3843
(503) 224-1998
Mailing address
5200 SW MACADAM AVE STE 100, PORTLAND, OR 97239-3843
(503) 224-1998
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
297624
OR
Other
Enumeration date
08/19/2013
Last updated
08/19/2013
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