Individual
KELLY DAWN HATTERSHIDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7931 NE HALSEY ST STE 200, PORTLAND, OR 97213-6755
(971) 803-0138
(971) 352-1088
Mailing address
34575 NOBLE RD, SAINT HELENS, OR 97051-9332
(503) 396-3848
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
19-12-22
OR
101YM0800X
Mental Health Counselor
19-QMHA-1-01054
OR
Other
Enumeration date
01/22/2018
Last updated
12/18/2025
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