Individual
KAITLYN SHEA LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10130 NE SKIDMORE ST, PORTLAND, OR 97220-3570
(503) 372-5147
(503) 266-8632
Mailing address
610 HIGH ST, OREGON CITY, OR 97045-2241
(503) 372-5147
(503) 266-8632
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
106S00000X
Behavior Technician
—
—
Other
Enumeration date
10/26/2020
Last updated
11/10/2025
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