Individual provider · Type 1 NPI

Tessa Rose Sicotte-Kelly

Student in an Organized Health Care Education/Training Program · Portland, OR

NPI number 1063389922 Active

Practice location

11261 NE Knott St
Portland, OR 97220-1704

Call (503) 253-8883 Map

Mailing address

PO Box 8459
Portland, OR 97207-8459

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1063389922

Tessa Rose Sicotte-Kelly's National Provider Identifier is 1063389922, issued on Oct 23, 2025. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Portland, OR. The record was last updated on Oct 23, 2025.