Individual
KELLY LONGWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
QMHA
Contact information
Practice address
445 3RD AVE SW, ALBANY, OR 97321-2272
(541) 829-2465
Mailing address
2773 SW WAKE ROBIN PL, CORVALLIS, OR 97333-1606
(541) 829-2465
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
02/01/2021
Last updated
02/01/2021
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