Individual
KERRA E BLAKELY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CADC, LCSW
Contact information
Practice address
3710 SW US VETERANS HOSPITAL RD, P3-PRRC, PORTLAND, OR 97239-2964
(503) 220-8262
Mailing address
PO BOX 1034, P3-PRRC, PORTLAND, OR 97207-1034
(503) 220-8262
(503) 273-5285
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
L3585
OR
Other
Enumeration date
08/24/2006
Last updated
03/17/2018
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