Individual
KELLY SELIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
5404 N MONTANA AVE, PORTLAND, OR 97217-4557
(503) 502-0208
(503) 961-8036
Mailing address
5404 N MONTANA AVE, PORTLAND, OR 97217-4557
(503) 502-0208
(503) 961-8036
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
L3485
OR
Other
Enumeration date
08/24/2007
Last updated
02/03/2023
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