Individual
KALEB KEATON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1027 E BURNSIDE ST, PORTLAND, OR 97214-1328
(503) 239-8400
Mailing address
15175 SW WALKER RD, BEAVERTON, OR 97006-4382
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
09/10/2012
Last updated
01/09/2017
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