Individual provider · Type 1 NPI

Jack Douglas Kelley, L.P.C.

Mental Health Counselor · Portland, OR

NPI number 1265873343 Active

Practice location

1027 E Burnside St
Portland, OR 97214-1328

Call (503) 239-8400 Map

Fax (503) 239-8406

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XC3282 (OR)

Mental Health Counselor: Definition to come...

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About NPI 1265873343

Jack Douglas Kelley, L.P.C.'s National Provider Identifier is 1265873343, issued on Jul 17, 2013. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Portland, OR. The record was last updated on Dec 17, 2013.