Organization
KELLY SELIS, LCSW
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY SELIS (PSYCHOTHERAPIST)
(503) 502-0208
Entity
Organization
Contact information
Practice address
1715 E. BURNSIDE ST., PORTLAND, OR 97214
(503) 502-0208
Mailing address
1715 E. BURNSIDE ST., PORTLAND, OR 97214
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
L3485
OR
Other
Enumeration date
10/20/2011
Last updated
10/20/2011
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