Individual
JILL KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1306 NW HOYT ST STE 407, PORTLAND, OR 97209-2787
(971) 407-3930
Mailing address
PO BOX 34703, SEATTLE, WA 98124-1703
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
C5967
OR
Other
Enumeration date
09/04/2016
Last updated
09/10/2024
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