Individual
DEBRA E KELLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
501 N DIXON ST, PORTLAND, OR 97227-1804
(503) 916-3326
Mailing address
1841 NE 125TH AVE, PORTLAND, OR 97230-1804
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
208199
OR
Other
Enumeration date
10/04/2007
Last updated
10/04/2007
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