NPI 1558892471

Kelly McMullen, LMT

Practitioner Prevention Professional Portland, OR

Practice location

Address: 819 SE Morrison St Suite 140, Portland, OR 97214-6307
Phone: (702) 480-6028

Registered specialties

Prevention Professional Primary

Other Service Providers Taxonomy 405300000X Licence 20211 (OR)

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Registry record

NPI: 1558892471
Entity type: Individual
Sex (as registered): Female
NPI issued: 22 Mar 2017
Record last updated: 22 Mar 2017

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.