Individual
KELSEY SMITH PAYNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BA, CADC I
Contact information
Practice address
537 SE ALDER ST, PORTLAND, OR 97214-2231
(503) 206-1059
Mailing address
3910 SE STARK ST, PORTLAND, OR 97214-3241
(503) 206-1059
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
13-06-52
OR
101YM0800X
Mental Health Counselor
—
—
Other
Enumeration date
09/17/2014
Last updated
01/21/2015
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