Individual
DEBBIE KIELTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12636 SE STARK ST BLDG J, PORTLAND, OR 97233-1058
(503) 253-4600
(503) 253-4609
Mailing address
2815 NE 25TH AVENUE, PORTLAND, OR 97212
(503) 709-2068
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
L6044
OR
Other
Enumeration date
09/14/2017
Last updated
09/14/2017
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