| Kelly Selis, Lcsw | |
|
1715 E. Burnside St. Portland OR 97214 | |
| (503) 502-0208 | |
| Not Available |
| Full Name | Kelly Selis, Lcsw |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 1715 E. Burnside St., Portland, Oregon |
| Authorized Official Name and Position | Kelly Selis (PSYCHOTHERAPIST) |
| Authorized Official Contact | 5035020208 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kelly Selis, Lcsw 1715 E. Burnside St. Portland OR 97214 Ph: () - | Kelly Selis, Lcsw 1715 E. Burnside St. Portland OR 97214 Ph: (503) 502-0208 |
| NPI Number | 1841575974 |
|---|---|
| Provider Enumeration Date | 10/20/2011 |
| Last Update Date | 10/20/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841575974 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | L3485 (Oregon) | Primary |
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