Individual provider · Type 1 NPI

Kelly Clark, BS, CADC I

Addiction (Substance Use Disorder) Counselor · Gresham, OR

NPI number 1861796641 Active

Practice location

400 NE 7th St
Gresham, OR 97030-5604

Call (503) 661-5455 Map

Fax (503) 661-4959

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor Primary 101YA0400XNone listed

Addiction (Substance Use Disorder) Counselor: Definition to come...

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About NPI 1861796641

Kelly Clark, BS, CADC I's National Provider Identifier is 1861796641, issued on Jan 7, 2011. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Gresham, OR. The record was last updated on Jan 7, 2011.