Individual
MELINDA KELLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
832 NE 162ND AVE, PORTLAND, OR 97230-5765
(231) 670-2695
Mailing address
722 NE 162ND AVE, PORTLAND, OR 97230-5760
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
01/12/2017
Last updated
01/12/2017
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