Individual provider · Type 1 NPI

David Allen Kelly Jr., CRNP

Family Nurse Practitioner · Portland, OR

NPI number 1639930779 Active

Practice location

3303 S Bond Ave
Portland, OR 97239-4501

Fax (503) 494-5385

Mailing address

1400 SW 5th Ave Ste 500
Portland, OR 97201-5537

Specialties and licenses

TaxonomyCodeLicense
Family Nurse Practitioner Primary 363LF0000X202207583NP-PP (OR)

Family Nurse Practitioner: Definition to come...

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About NPI 1639930779

David Allen Kelly Jr., CRNP's National Provider Identifier is 1639930779, issued on Jan 16, 2024. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Portland, OR. The record was last updated on May 7, 2024.