| Kellee Purdy, Llc | |
|
1832 Ne Broadway St Portland OR 97232-1992 | |
| (971) 227-9277 | |
| Not Available |
| Full Name | Kellee Purdy, Llc |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 1832 Ne Broadway St, Portland, Oregon |
| Authorized Official Name and Position | Kellee Purdy (OWNER) |
| Authorized Official Contact | 9712279277 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kellee Purdy, Llc 2717 Se 64th Ave Portland OR 97206-1373 Ph: (971) 227-9277 | Kellee Purdy, Llc 1832 Ne Broadway St Portland OR 97232-1992 Ph: (971) 227-9277 |
| NPI Number | 1174941066 |
|---|---|
| Provider Enumeration Date | 03/28/2014 |
| Last Update Date | 03/28/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174941066 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | 4182 (Oregon) | Primary |
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