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Individual

MALLORY KILMURRAY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
19875 SW 65TH AVE STE 100, TUALATIN, OR 97062-8353
(503) 612-3187
Mailing address
19875 SW 65TH AVE STE 100, TUALATIN, OR 97062-8353

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
23-09-10862
OR
1041C0700X
Clinical Social Worker
Primary
L16974
OR
172V00000X
Community Health Worker

Other

Enumeration date
05/23/2018
Last updated
11/12/2025
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