Individual
KAELYN HICKEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
X
Contact information
Practice address
811-815 SE SHERMAN ST, PORTLAND, OR 97214
(971) 229-9527
Mailing address
811-815 SE SHERMAN ST, PORTLAND, OR 97214
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
03/25/2026
Last updated
03/25/2026
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