Individual
KELLY RICHARDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CADC II
Contact information
Practice address
14255 SW BRIGADOON CT, BEAVERTON, OR 97005-3369
(503) 641-1475
Mailing address
14600 NW CORNELL RD, PORTLAND, OR 97229-5442
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
12/29/2016
Last updated
03/07/2017
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