Individual
NICOLE C KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1470 NW 4TH ST, REDMOND, OR 97756-1366
(541) 316-7520
(541) 504-5505
Mailing address
1470 NW 4TH ST, REDMOND, OR 97756-1366
(541) 316-7520
(541) 504-5505
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
09/02/2025
Last updated
09/02/2025
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