Individual
ROBERT KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA, CADC-I
Contact information
Practice address
227 NW 3RD AVE, CANBY, OR 97013-3640
(503) 416-4547
(503) 416-4553
Mailing address
7320 SW HUNZIKER RD STE 300, PORTLAND, OR 97223-2302
(503) 941-3033
(503) 747-7013
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500764578
—
OR
Enumeration date
02/11/2019
Last updated
03/14/2026
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