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1952846032
KELLY RICHARDSON
BEAVERTON, OR
NPI
1952846032
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2016-12-29
Last Update Date
2017-03-07
Business Address
-- KELLY RICHARDSON CADC II
14255 SW BRIGADOON CT
BEAVERTON, OR 97005-3369
Phone number: 503-641-1475
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Mailing Address
-- KELLY RICHARDSON CADC II
14600 NW CORNELL RD
PORTLAND, OR 97229-5442
Phone number:
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