Kelley, Peggy E

Kelley, Peggy E is an individual health care provider with primary practice located at 9427 Sw Barnes Rd Ste 395 , Portland OR 97225-6652. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatric Otolaryngology, which is considered as her primary health care specialty. Kelley, Peggy E can be contacted via phone (503) 216-6050.

Contact Information

Primary practice address
9427 Sw Barnes Rd Ste 395 Portland OR 97225-6652
Phone: (503) 216-6050
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatric Otolaryngology 207YP0228X 37368 Colorado
Allopathic & Osteopathic Physicians / Pediatric Otolaryngology 207YP0228X MD196930 Oregon

Profile Details

NPI number 1689777476
LBN Legal business name Kelley, Peggy E
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 7th, 2006
Last updated Mar 18th, 2021 - about 3 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 1689777476 NPPES
Colorado MEDICAID 01373687

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