Most Relevant Information
Provider Data
| NPI Number: | 1003347774 |
| Provider Name: | KAYLEE PURPURA |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 03/24/2017 |
| Last Updated: | 06/09/2022 |
Provider Practice Location
3181 SW SAM JACKSON PARK RD
PORTLAND
OR
972393011
Practice Location Phone/Fax
| Phone: | 5034948510 |
| Fax: | 5034944631 |
Provider Mailing Location
3181 SW SAM JACKSON PARK RD
PORTLAND
OR
972393011
Provider Mailing Phone/Fax
| Phone: | 5034948510 |
| Fax: | 5034944631 |