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Individual

MS. KAREN GAYE KELLY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
4431 SE WOODSTOCK BLVD, PORTLAND, OR 97206-6271
(503) 765-6221
Mailing address
6206 SE 30TH AVE, PORTLAND, OR 97202-8602
(503) 765-6221

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
R3372
OR
106H00000X
Marriage & Family Therapist
Primary
R3372
OR

Other

Enumeration date
04/16/2015
Last updated
04/16/2015
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