Individual
LISA MARIE KALILNOWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CADC1
Contact information
Practice address
2367 S ROOSEVELT DR, SEASIDE, OR 97138-6550
(971) 320-3130
(503) 738-2116
Mailing address
1027 E BURNSIDE ST, PORTLAND, OR 97214-1328
(503) 239-8400
(503) 239-8407
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
08/14/2020
Last updated
08/14/2020
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