Provider Demographics
NPI:1235374802
Name:WRIGHT, KEVIN LEIGH (MS)
Entity Type:Individual
Prefix:MR
First Name:KEVIN
Middle Name:LEIGH
Last Name:WRIGHT
Suffix:
Gender:M
Credentials:MS
Other - Prefix:MR
Other - First Name:KEVIN
Other - Middle Name:LEIGH
Other - Last Name:WRIGHT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS, LPC
Mailing Address - Street 1:PO BOX 2344
Mailing Address - Street 2:
Mailing Address - City:CLACKAMAS
Mailing Address - State:OR
Mailing Address - Zip Code:97015-2344
Mailing Address - Country:US
Mailing Address - Phone:503-961-2388
Mailing Address - Fax:
Practice Address - Street 1:5197 SE KING RD
Practice Address - Street 2:
Practice Address - City:MILWAUKIE
Practice Address - State:OR
Practice Address - Zip Code:97222-4334
Practice Address - Country:US
Practice Address - Phone:503-961-2388
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-10
Last Update Date:2008-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional