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1457545899
SERENA PHROMSIVARAK KELLY
PORTLAND, OR
NPI
1457545899
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363LA2100X Nurse Practitioner, Acute Care
(Licence: OR 200750101)
Enumeration Date
2007-08-29
Last Update Date
2016-11-16
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
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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
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