Individual
KELLY SNYDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
400 NE 7TH ST, GRESHAM, OR 97030
(503) 661-5455
Mailing address
3905 SE 147TH AVE, 97236, PORTLAND, OR 97236-2533
(503) 772-1039
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
OR
Other
Enumeration date
05/31/2016
Last updated
05/31/2016
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