KATHLEEN KETELSON (NPI# 1033428198) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033428198 |
| Entity Type | Individual |
| Full Name | KATHLEEN KETELSON |
| Credential | FNP |
| Practice Address |
560 Wallace Rd Nw Ste 140 Salem OR 97304 |
| Mailing Address |
560 Wallace Rd Nw Ste 140 Salem OR 97304-3858 |
| Practice Telephone | 8885248219 |
| Mailing Telephone | 8885248219 |
| Enumeration Date | 2010-10-06 |
| Last Update Date | 2018-10-03 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
201050158NP | OR | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | STATE LICENSE | 201050158NP | 01 |
| OR | 500627501 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2001 Nw Monroe Ave, Suite 104, Corvallis, OR 973305508 | 5417541369 |
| Street Address |
560 WALLACE RD NW STE 140 |
| City | SALEM |
| State | OR |
| Zip Code | 97304 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235657156 | Swiftcare LLC | Clinic/Center | 560 Wallace Rd Nw Ste 140, Salem, OR 97304-3858 | 2017-08-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114413010 | Sam Mackenzie Lane | Massage Therapist | 1661 Edgewater St Nw # 120, Salem, Or 97304, Salem, OR 97304 | 2018-07-03 |
| 1144761131 | Rachel E Carson | Physical Therapist | 1025 2nd St. Nw, West Salem, OR 97304 | 2017-03-10 |
| 1962951061 | Lee Ann Nail | Social Worker | 3965 Gibson Rd Nw, Salem, OR 97304 | 2016-09-29 |
| 1619421591 | Logan Walters | Physical Therapist | 1025 2nd St Nw, Salem, OR 97304 | 2016-08-09 |
| 1770941338 | Tysandra Gillis | Massage Therapist | 859 Mule Deer St., Salem, OR 97304 | 2016-02-10 |
| 1144620295 | Molly Rodden | Nurse Practitioner | 1174 Cornucopia St Nw Ste 240, Salem, OR 97304 | 2014-08-26 |
| 1881942126 | Cynthia Ruth Rettler | Registered Nurse | 1520 Plaza St Nw Ste 150, Salem, OR 97304 | 2012-08-16 |
| 1336401017 | Trillium Family Services | Community/Behavioral Health | 1520 Plaza Street Nw, Suite 100, Salem, OR 97304 | 2012-06-08 |
| 1922332535 | Robert Scott Mcadam | Social Worker | 1245 Edgewater St. Nw, Salem, OR 97304 | 2009-09-29 |
| 1992932560 | Michelle Lynn Laseter | Counselor | 290 Moyer Ln. Nw, Salem, OR 97304 | 2009-06-22 |
| Find all providers in zip 97304 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285247908 | Tracy Jean Payton | Nurse Practitioner | 3898 Lee Road 250, Salem, AL 36874-1450 | 2020-08-24 |
| 1437775137 | Krista Michelle Brinkerhoff | Nurse Practitioner | 636 N 220 E, Salem, UT 84653-5553 | 2020-06-18 |
| 1851913271 | Rossiel Pita-roman | Nurse Practitioner | 25 Oak Ridge Ave Apt 10, Salem, NH 03079-4480 | 2020-05-07 |
| 1487292157 | Kelly Daily Morris | Nurse Practitioner | 5915 Port Stewart Ct Se, Salem, OR 97306-9034 | 2019-12-12 |
| 1174087985 | Brenda Gott | Nurse Practitioner | 3103 Hh Highway, Salem, MO 65560 | 2019-01-25 |
| 1992277594 | Shelisa Rena Taylor | Nurse Practitioner | 1126 Lee Road 250, Salem, AL 36874-1373 | 2018-12-19 |
| 1811472426 | Kathryn B Powell | Nurse Practitioner | 400 Highland Ave Ste 1, Salem, MA 01970-1783 | 2018-09-28 |
| 1609367077 | Jennifer Turner | Nurse Practitioner | 225 Sunbridge Drive, Salem, WV 26426 | 2018-05-22 |
| 1174042535 | Elizabeth Keane | Nurse Practitioner | 9 Riverbank Rd, Salem, MA 01970-5311 | 2017-09-15 |
| 1346766292 | Scott Adam Pasquale | Nurse Practitioner | 331r Highland Ave, Salem, MA 01970-1738 | 2017-08-22 |
| Find all providers in SALEM | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.