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General NPI Number Information
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NPI Number | 1225838162
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Entity Type | Individual
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Provider Name | MRS. KAELEY COLLEEN O'LEARY STEPHENS
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Gender | Female
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Dates
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Enumeration Date | 03/18/2025
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Last Update Date | 03/18/2025
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Provider Practice Location Address
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Address Line | 1498 SE TECH CENTER PL STE 180
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City | VANCOUVER
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State | WA
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Zip | 98683-5518
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Country | US
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Telephone | 360-200-8670
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Fax |
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Provider Business Mailing Address
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Address Line | 2820 SE 33RD PL
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City | PORTLAND
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State | OR
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Zip | 97202-1433
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Country | US
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Telephone | 503-318-8004
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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