Individual
JERRY KEITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
870 82ND DR BLDG C, GLADSTONE, OR 97027-1803
(503) 659-5515
Mailing address
870 82ND DR BLDG C, GLADSTONE, OR 97027-1803
(541) 399-2729
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
C10718
OR
Other
Enumeration date
03/24/2023
Last updated
11/08/2025
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