Individual provider · Type 1 NPI

Nathan Kennelly, CRM, CADC R

Addiction (Substance Use Disorder) Counselor · Gresham, OR

NPI number 1871304279 Active

Practice location

1217 NE Burnside Rd Ste 701
Gresham, OR 97030-5770

Call (503) 740-6449 Map

Mailing address

10117 SE Sunnyside Rd # F1217
Clackamas, OR 97015-7708

Specialties and licenses

TaxonomyCodeLicense
Peer Specialist 175T00000XNone listed
Addiction (Substance Use Disorder) Counselor Primary 101YA0400XNone listed

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

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About NPI 1871304279

Nathan Kennelly, CRM, CADC R's National Provider Identifier is 1871304279, issued on Jan 15, 2025. 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 15, 2025.