Most Relevant Information
Provider Data
NPI Number: | 1003323809 |
Provider Name: | MICHELLE LEA KELLER |
Entity Type: | Individual |
Taxonomy Code: | 1041C0700X |
Specialty: | Social Worker |
License Number: |
Most Important Dates
Enumeration Date: | 01/03/2018 |
Last Updated: | 01/03/2018 |
Provider Practice Location
3710 SW US VETERANS HOSPITAL RD
PORTLAND
OR
972392964
Practice Location Phone/Fax
Phone: | 5032208262 |
Fax: |
Provider Mailing Location
415 SW 14TH CT
CANBY
OR
970138815
Provider Mailing Phone/Fax
Phone: | |
Fax: |