Bartholomew, Kelly Mahara

Bartholomew, Kelly Mahara is an individual health care provider with primary practice located at 2226 Nw Pettygrove , Portland OR 97210. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Surgical, which is considered as her primary health care specialty. Bartholomew, Kelly Mahara can be contacted via phone (503) 223-6223.

Contact Information

Primary practice address
2226 Nw Pettygrove Portland OR 97210
Phone: (503) 223-6223
Fax: (503) 223-3665
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X Oregon

Profile Details

NPI number 1255328290
LBN Legal business name Bartholomew, Kelly Mahara
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 4th, 2005
Last updated May 1st, 2015 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1255328290 NPPES
Oregon MEDICAID PA00693

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