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1245582196
KELLY A BURGESS
PORTLAND, OR
NPI
1245582196
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2012-10-02
Last Update Date
2016-01-11
Business Address
-- KELLY A BURGESS
847 NE 19TH AVE SUITE 1000
PORTLAND, OR 97232-2684
Phone number: 503-238-0769
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Mailing Address
-- KELLY A BURGESS
PO BOX 8459
PORTLAND, OR 97207-8459
Phone number: 503-238-0769
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