Search › Oregon › 171100000X
Kelly Ilseman, MACOM, MS, MED
NPI 1669059291 · on the registry since 2021
Practice
- Address
- 729 E Burnside St Ste 109
Portland, OR 97214 - Phone
- (617) 784-2320
Registry record
- Primary taxonomy
- 171100000X
171100000X
- Licence states on file
- OR
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2021-07-22
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Oregon