Individual
DANIEL KELSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
4816 NW BETHANY BLVD, PORTLAND, OR 97229-9254
(503) 439-9014
Mailing address
4816 NW BETHANY BLVD, PORTLAND, OR 97229-9254
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
RPH-0015006
OR
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
RPH-0015006
OR
Other
Enumeration date
09/28/2015
Last updated
07/17/2017
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