Provider Demographics
NPI:1235733783
Name:RICE, KELLY ANN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:KELLY
Middle Name:ANN
Last Name:RICE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:1130 NW 22ND AVE STE LL10
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97210-2974
Mailing Address - Country:US
Mailing Address - Phone:503-413-6590
Mailing Address - Fax:503-413-6872
Practice Address - Street 1:1130 NW 22ND AVE STE LL10
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97210-2974
Practice Address - Country:US
Practice Address - Phone:503-413-6590
Practice Address - Fax:503-413-6872
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-25
Last Update Date:2020-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORRPH-00073991835X0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835X0200XPharmacy Service ProvidersPharmacistOncology