KELLY RICHARDSON

BEAVERTON, OR
NPI1952846032
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date2016-12-29
Last Update Date2017-03-07
Business Address
-- KELLY RICHARDSON CADC II
14255 SW BRIGADOON CT
BEAVERTON, OR 97005-3369
Phone number: 503-641-1475
Mailing Address
-- KELLY RICHARDSON CADC II
14600 NW CORNELL RD
PORTLAND, OR 97229-5442
Phone number:
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