Individual
KELLY ANN SPAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CADC I
Contact information
Practice address
2600 SE BELMONT ST, PORTLAND, OR 97214-2916
(503) 239-5738
(503) 963-9026
Mailing address
2600 SE BELMONT ST, PORTLAND, OR 97214-2916
(503) 239-5738
(503) 963-9026
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
23-R-18
OR
Other
Enumeration date
11/21/2022
Last updated
07/17/2023
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