Most Relevant Information
Provider Data
| NPI Number: | 1003321639 |
| Provider Name: | KELSEY E MCIRVIN |
| Entity Type: | Individual |
| Taxonomy Code: | 175T00000X |
| Specialty: | Peer Specialist |
| License Number: |
Most Important Dates
| Enumeration Date: | 12/05/2017 |
| Last Updated: | 12/05/2017 |
Provider Practice Location
514 SE 8TH AVE
HILLSBORO
OR
971234521
Practice Location Phone/Fax
| Phone: | 5037470669 |
| Fax: |
Provider Mailing Location
PO BOX 16756
PORTLAND
OR
972920756
Provider Mailing Phone/Fax
| Phone: | 9713313276 |
| Fax: |