Individual
JEFFREY TODD KITSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CADCI, QMHA
Contact information
Practice address
8915 SW CENTER ST, TIGARD, OR 97223-6307
(503) 726-3740
Mailing address
2521 SE 74TH AVE, PORTLAND, OR 97206-1150
(503) 597-3902
(503) 597-3903
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
OR
171M00000X
Case Manager/Care Coordinator
Primary
—
OR
Other
Enumeration date
12/11/2007
Last updated
01/16/2018
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