Kelly, Serena Phromsivarak
Kelly, Serena Phromsivarak is an sole proprietor health care provider with primary practice located at 3181 Sw Sam Jackson Park Rd Mail Code Dc8N, Portland OR 97239-3011. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Acute Care, which is considered as her primary health care specialty. Kelly, Serena Phromsivarak can be contacted via phone (503) 418-5881.Contact Information
Primary practice address
3181 Sw Sam Jackson Park Rd Mail Code Dc8N
Portland OR 97239-3011
Phone: (503) 418-5881
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Acute Care | 363LA2100X | 200750101 | Oregon |
Profile Details
| NPI number | 1457545899 |
|---|---|
| LBN Legal business name | Kelly, Serena Phromsivarak |
| Credentials | ACPNP |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 29th, 2007 |
| Last updated | Nov 16th, 2016 - about 8 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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