Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0300X | Geriatric Medicine | MD153981 | OR |
NPI | 1093916470 |
---|---|
Provider Name | Dr. Kellie Rooney Foster |
First Address | Portland, OR 97210-5344 |
Second Address | Portland, OR 97210-5344 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/05/2007 |
Last Update Date | 01/02/2022 |