Individual
KRISTEN KELLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CSWA
Contact information
Practice address
10180 SE SUNNYSIDE RD, CLACKAMAS, OR 97015-8970
(805) 901-0962
Mailing address
PO BOX 8459, PORTLAND, OR 97207-8459
(503) 238-0769
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
A5600
OR
Other
Enumeration date
06/08/2015
Last updated
12/24/2021
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