Individual
KELSEY LUDWIG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
6800 SW 105TH AVE STE 101, BEAVERTON, OR 97008-5488
(971) 200-1966
(971) 754-4141
Mailing address
6800 SW 105TH AVE STE 101, BEAVERTON, OR 97008-5488
(971) 200-1966
(971) 754-4141
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
C5176
OR
101Y00000X
Counselor
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500739768
—
OR
Enumeration date
11/27/2013
Last updated
06/15/2022
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