KATHLEEN KELLEY (NPI# 1568691756) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568691756 |
| Entity Type | Individual |
| Full Name | KATHLEEN KELLEY |
| Credential | PMHNP |
| Practice Address |
15110 Boones Ferry Rd Ste 248 Lake Oswego OR 97035-3498 |
| Practice Telephone | 5038303215 |
| Practice Fax Number | 5036994133 |
| Mailing Telephone | 5038303215 |
| Mailing Fax Number | 5036994133 |
| Enumeration Date | 2009-07-08 |
| Last Update Date | 2011-12-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
200950083NP | OR | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972910925 | Kathleen Kelley | Social Worker | 2813e Wyoming Dr, Sinking Spring, PA 19608-1618 | 2014-07-22 |
| 1477617447 | Kathleen Kelley | Counselor | 99 University Place, 4th Floor, New York, NY 10003-8971 | 2006-12-21 |
| 1649388513 | Kathleen M Kelley | Nurse Practitioner | 1952 Long Grove Dr, Suite 202, Mt Pleasant, SC 29464 | 2006-08-29 |
| 1265443014 | Kathleen Cranford Kelley | Nurse Practitioner | 1092 General George Patton Rd, Nashville, TN 37221-2599 | 2006-08-10 |
| 1871501353 | Kathleen Ann Kelley | Pharmacist | 2943 Seneca Street, West Seneca, NY 14224-1950 | 2006-08-03 |
| 1992760797 | Kathleen S. Kelley | Internal Medicine | 498 University Blvd, Suite F, Harrisonburg, VA 22801 | 2006-04-18 |
| 1952773525 | Kathleen Kelley | Physician Assistant | 464 Congress Ave, Suite 260, New Haven, CT 06519-1361 | 2015-10-22 |
| 1245626225 | Kathleen Kelley | Dermatology | 1815 E Ireland Rd, South Bend, IN 46614 | 2015-04-07 |
| 1861882557 | Kathleen Helen Kelley | Dietitian, Registered | 15 Palomba Dr, 2, Enfield, CT 06082-3888 | 2015-02-02 |
| 1285961839 | Kathleen Kelley | Physical Therapist | 800 Kensington Ave Ste 100, Missoula, MT 59801-5670 | 2009-11-03 |
| Street Address |
15110 BOONES FERRY RD STE 248 |
| City | LAKE OSWEGO |
| State | OR |
| Zip Code | 97035-3498 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932700127 | Teresa Siebenaler Scott | Social Worker | 3990 Sw Collins Way, Suite 202, Lake Owsego, OR 97035 | 2020-11-04 |
| 1528671567 | Martin Henry Lees | Internal Medicine | 14 Morningview Lane, Lake Oswego, OR 97035 | 2020-08-28 |
| 1356976187 | Premere Rehab LLC | Occupational Therapist | Infinity Rehab - The Springs At Lake Oswego, 3900 Kruse Way Pl, Lake Oswego, OR 97035 | 2020-03-12 |
| 1689212193 | Jennifer Chauvin | Nurse Practitioner | 20 Juarez Street, Lake Oswego, OR 97035 | 2019-12-16 |
| 1003396888 | Sarah Guenzburger | Physical Therapist | 3900 Kruse Way Pl, Lake Oswego, OR 97035 | 2018-08-21 |
| 1568964252 | Brett Johnson | Marriage & Family Therapist | 5655 Southwood Dr, Lake Oswego, OR 97035 | 2018-03-08 |
| 1912416561 | Michael Paul Long | Social Worker | 14523 Westlake Drive, Lake Oswego, Or 97035, Lake Oswego, OR 97035 | 2017-09-27 |
| 1467807859 | Misty Lohn | Nurse Practitioner | 5 Centerpointe Dr., Ste 600, Lake Oswego, OR 97035 | 2016-05-04 |
| 1326405473 | Kelsey Prince | Behavioral Analyst | 6400 Sw Rosewood St., Portland (lake Oswego), OR 97035 | 2016-01-20 |
| 1942683388 | Elizabeth Risberg Harrison | Massage Therapist | 190 Oswego Summit, Lake Oswego, OR 97035 | 2015-07-02 |
| Find all providers in zip 97035 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689212193 | Jennifer Chauvin | Nurse Practitioner | 20 Juarez Street, Lake Oswego, OR 97035 | 2019-12-16 |
| 1548748825 | Julia C Bishop-taylor Pmhnp LLC | Nurse Practitioner | 14523 Westlake Dr Ste 4, Lake Oswego, OR 97035-7700 | 2018-07-30 |
| 1083039457 | Kristine Heenk | Nurse Practitioner | 14523 Westlake Dr Ste 25, Lake Oswego, OR 97035-7700 | 2014-02-21 |
| 1295164044 | Melody Becker Jones | Nurse Practitioner | 4860 Centerwood St, Lake Oswego, OR 97035-8203 | 2013-11-02 |
| 1386071801 | Julia Cherie Bishop-taylor | Nurse Practitioner | 14523 Westlake Dr # 4, Lake Oswego, OR 97035 | 2013-09-29 |
| 1568742831 | Abigail Bohn | Nurse Practitioner | 6025 Jean Rd Ste B, Lake Oswego, OR 97035-5307 | 2011-08-18 |
| 1730230970 | Juliet Walters Bissett | Nurse Practitioner | 201 B Ave, Suite 255, Lake Oswego, OR 97034-3159 | 2007-01-15 |
| 1689110868 | Portland Integrative Psychiatry | Nurse Practitioner | 14523 Westlake Dr, 4, Lake Oswego, OR 97035-7700 | 2017-01-12 |
| 1255453437 | Susan Jill Hazel | Nurse Practitioner | 15100 Boones Ferry Rd, #700, Lake Oswego, OR 97035-3469 | 2007-04-06 |
| 1124195722 | Maureen Conway | Nurse Practitioner | 17704 Jean Way, Suite 105, Lake Oswego, OR 97035-5497 | 2006-11-29 |
| Find all providers in LAKE OSWEGO | ||||
| City | LAKE OSWEGO |
| Zip Code | 97035 |
Please comment or provide details below to improve the information on KATHLEEN KELLEY.
| 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.