Individual
KELLY JEAN CLEAVES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
18650 NW CORNELL RD, STE 315, HILLSBORO, OR 97124-9207
(503) 352-0468
Mailing address
12160 SW FAIRCREST ST, PORTLAND, OR 97225-4620
(402) 650-8834
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
DO172166
OR
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/25/2012
Last updated
05/09/2017
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