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Individual
ERIC KELLER
Active
Individual
ERIC KELLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
OR
174400000X
Specialist
MA00020790
WA
390200000X
Student in an Organized Health Care Education/Training Program
Primary
CO61669207
WA
Other
Enumeration date
07/09/2008
Last updated
09/23/2026
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