Individual
JOHN PAUL KELLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
QMHA
Contact information
Practice address
709 NW EVERETT ST, PORTLAND, OR 97209-3517
(503) 737-7513
(503) 737-7513
Mailing address
7916 N EMERALD AVE, PORTLAND, OR 97217-6116
(503) 737-7513
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
01/22/2007
Last updated
06/24/2010
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