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1518590629
TIMOTHY KELLY
PORTLAND, OR
NPI
1518590629
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
175T00000X Peer Specialist
Enumeration Date
2020-02-17
Last Update Date
2020-02-17
Business Address
TIMOTHY KELLY
14600 NW CORNELL RD
PORTLAND, OR 97229-5442
Phone number: 503-645-3581
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Mailing Address
TIMOTHY KELLY
14600 NW CORNELL RD
PORTLAND, OR 97229-5442
Phone number: 503-645-3581
Copy
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