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1649628645
KELLY SNYDER
GRESHAM, OR
NPI
1649628645
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2016-05-31
Last Update Date
2016-05-31
Business Address
-- KELLY SNYDER
400 NE 7TH ST
GRESHAM, OR 97030
Phone number: 503-661-5455
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Mailing Address
-- KELLY SNYDER
3905 SE 147TH AVE 97236
PORTLAND, OR 97236-2533
Phone number: 503-772-1039
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