SERENA PHROMSIVARAK KELLY

PORTLAND, OR
NPI1457545899
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy363LA2100X Nurse Practitioner, Acute Care
(Licence: OR  200750101)
Enumeration Date2007-08-29
Last Update Date2016-11-16
Business Address
Mrs. SERENA PHROMSIVARAK KELLY ACPNP
3181 SW SAM JACKSON PARK RD MAIL CODE DC8N
PORTLAND, OR 97239-3011
Phone number: 503-418-5881
Mailing Address
Mrs. SERENA PHROMSIVARAK KELLY ACPNP
3181 SW SAM JACKSON PARK RD MAIL CODE: DC8N
PORTLAND, OR 97239-3011
Phone number: 503-418-5881