Individual
KELLY L GOODMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
421 SW OAK ST, 210, PORTLAND, OR 97204-1817
(503) 988-3674
(503) 988-5180
Mailing address
426 SW STARK ST, 8TH FLOOR, PORTLAND, OR 97204-2347
(503) 988-3674
(503) 988-5180
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
3559
OR
Other
Enumeration date
03/01/2007
Last updated
12/11/2009
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