Individual
MISS KELSEY CORRINE COFFEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1500 NE IRVING ST, SUITE 250, PORTLAND, OR 97232-2243
(503) 233-4356
Mailing address
16272 SE LILLIAN CT, MILWAUKIE, OR 97267-5344
(503) 381-1925
Taxonomy
Speciality
Code
Description
License number
State
3245S0500X
Children's Substance Abuse Rehabilitation Facility
Primary
—
—
Other
Enumeration date
01/11/2009
Last updated
01/11/2009
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