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Individual

MRS. KELLY BETH PEREZ DE LA CRUZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MSW, LCSW

Contact information

Practice address
1500 NW BETHANY BLVD STE 320, BEAVERTON, OR 97006-5238
(503) 567-3260
Mailing address
1188 SE 62ND AVE, HILLSBORO, OR 97123-2967
(360) 430-0863

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
1041C0700X
Clinical Social Worker
L7818
OR

Other

Enumeration date
10/03/2013
Last updated
04/04/2024
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