KELLEY STEWART WILSON

PORTLAND, OR
NPI1942224332
Former NameKELLEY YVONNE STEWART
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy1223G0001X Dentist, General Practice
(Licence: OR  D7960)
Additional Taxonomies122300000X Dentist
(Licence: OR  d7960)
Enumeration Date2006-07-27
Last Update Date2011-09-07
Business Address
-- KELLEY STEWART WILSON DMD
5025 SE 28TH AVE
PORTLAND, OR 97202-4445
Phone number: 503-238-4418
Mailing Address
-- KELLEY STEWART WILSON DMD
19075 NW TANASBOURNE DR. #300 SUNSET DENTAL OFFICE
HILLBORO, OR 97124
Phone number: 503-531-1700