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
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #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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