Kelly, Lori H

Kelly, Lori H is an individual health care provider with primary practice located at 3303 Sw Bond Ave , Portland OR 97239-4501. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as her primary health care specialty. Kelly, Lori H can be contacted via phone (503) 494-4373.

Contact Information

Primary practice address
3303 Sw Bond Ave Portland OR 97239-4501
Phone: (503) 494-4373
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X PA00942 Oregon

Profile Details

NPI number 1689670226
LBN Legal business name Kelly, Lori H
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 27th, 2005
Last updated Aug 23rd, 2010 - about 16 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 1689670226 NPPES
Oregon MEDICAID 500602706
Oregon MEDICAID 8502619

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