Provider Demographics
NPI:1255926325
Name:VOISIN, KELSEY (PA-C)
Entity type:Individual
Prefix:
First Name:KELSEY
Middle Name:
Last Name:VOISIN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7545 SW CRESTVIEW ST
Mailing Address - Street 2:
Mailing Address - City:TIGARD
Mailing Address - State:OR
Mailing Address - Zip Code:97223-8206
Mailing Address - Country:US
Mailing Address - Phone:803-316-2597
Mailing Address - Fax:
Practice Address - Street 1:7545 SW CRESTVIEW ST
Practice Address - Street 2:
Practice Address - City:TIGARD
Practice Address - State:OR
Practice Address - Zip Code:97223-8206
Practice Address - Country:US
Practice Address - Phone:803-316-2597
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-01
Last Update Date:2021-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR199019363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR199019OtherOREGON MEDICAL BOARD
1167875OtherNCCPA