Individual
SHILETHA KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2600 SE BELMONT ST, PORTLAND, OR 97214-2916
(503) 239-5738
Mailing address
22745 NE HALSEY ST APT 82, FAIRVIEW, OR 97024-4607
(503) 724-2251
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
06/01/2016
Last updated
06/01/2016
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