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1295211001
SCOTT EDWARD KELLY
PORTLAND, OR
NPI
1295211001
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
104100000X Social Worker
Enumeration Date
2018-07-15
Last Update Date
2018-07-15
Business Address
Mr. SCOTT EDWARD KELLY
707 NE COUCH ST
PORTLAND, OR 97232-2922
Phone number: 503-542-4603
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Mailing Address
Mr. SCOTT EDWARD KELLY
967 SW 185TH AVE APT 1
BEAVERTON, OR 97003-6659
Phone number: 503-998-1216
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