Individual
KELLAN BECKHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1215 SW 18TH AVE, PORTLAND, OR 97205-1711
(503) 841-6401
Mailing address
1010 SE 11TH AVE, PORTLAND, OR 97214-2562
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
A18415
OR
175T00000X
Peer Specialist
Primary
—
WA
Other
Enumeration date
04/07/2020
Last updated
07/23/2026
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