# WISTER PARK COUNSELING, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1043683105
- **Authorized official:** MR. BYRON W KEHLER M.S. (PRESIDENT)
- **Authorized official phone:** (503) 277-9780

## Contact information

- **Practice address:** 11630 SE 40TH AVE, STE. A, MILWAUKIE, OR 97222-6195
- **Practice address phone:** (503) 277-9780
- **Mailing address:** 11630 SE 40TH AVE, STE. A, MILWAUKIE, OR 97222-6195
- **Mailing address phone:** (503) 715-7308

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251K00000X | Public Health or Welfare Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 11/10/2015
- **Last updated:** 11/10/2015