Individual
THOMAS EUGENE KELLEY III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA
Contact information
Practice address
2507 CHRISTIE DRIVE, LAKE OSWEGO, OR 98034
(503) 635-3416
Mailing address
7800 SW CAPITOL HILL RD, PORTLAND, OR 97219-2686
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
—
—
Other
Enumeration date
03/13/2007
Last updated
07/08/2007
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