TIMOTHY KEVIN KELLY

CLACKAMAS, OR
NPI1710082979
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YM0800X Counselor, Mental Health
(Licence: OR  OR C0220)
Enumeration Date2006-09-13
Last Update Date2007-07-08
Business Address
Mr. TIMOTHY KEVIN KELLY M.S.
10163 SE SUNNYSIDE RD STE 490
CLACKAMAS, OR 97015-5720
Phone number: 503-653-3451
Mailing Address
Mr. TIMOTHY KEVIN KELLY M.S.
4454 NE MASON ST
PORTLAND, OR 97218-1739
Phone number: 503-254-7996