Provider Demographics
NPI:1225838162
Name:O'LEARY STEPHENS, KAELEY COLLEEN
Entity type:Individual
Prefix:MRS
First Name:KAELEY
Middle Name:COLLEEN
Last Name:O'LEARY STEPHENS
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2820 SE 33RD PL
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97202-1433
Mailing Address - Country:US
Mailing Address - Phone:503-318-8004
Mailing Address - Fax:
Practice Address - Street 1:1498 SE TECH CENTER PL STE 180
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98683-5518
Practice Address - Country:US
Practice Address - Phone:360-200-8670
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-18
Last Update Date:2025-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist