DR. KELLY OTTO (NPI# 1144475302) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144475302 |
| Entity Type | Individual |
| Full Name | DR. KELLY OTTO |
| Credential | D.C. |
| Practice Address |
9735 Sw Shady Ln Ste 303 Tigard OR 97223-5481 |
| Practice Telephone | 5036841273 |
| Practice Fax Number | 5036841274 |
| Mailing Telephone | 5036841273 |
| Mailing Fax Number | 5036841274 |
| Enumeration Date | 2008-12-01 |
| Last Update Date | 2008-12-01 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | 3885 | OR | Chiropractic Providers |
| Street Address |
9735 SW SHADY LN STE 303 |
| City | TIGARD |
| State | OR |
| Zip Code | 97223-5481 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477817674 | Barbara Dawn Zibrida | Massage Therapist | 9735 Sw Shady Ln Ste 303, Tigard, OR 97223-5481 | 2012-07-02 |
| 1629206271 | All Body Chiropractic, LLC | Chiropractor | 9735 Sw Shady Ln Ste 303, Tigard, OR 97223-5481 | 2009-06-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760042618 | Tess Ivie Manso | Counselor | 8915 Degrees Center St, Tigard, OR 97223 | 2019-06-13 |
| 1780141804 | Amybrunermd LLC | Obstetrics & Gynecology | 6958 Sw Varns Street, Portland, OR 97223 | 2019-02-25 |
| 1417425034 | Patience Marie Rutto | Counselor | 8915 Sw Center Streret, Tigard, OR 97223 | 2018-11-13 |
| 1871089581 | Marina E Menegol | Behavioral Analyst | Center for Social Dynamics, 9115 Southwest Oleson Rd. Ste. 100, Portland, OR 97223 | 2018-07-05 |
| 1215423165 | Katherine Virginia Eichner | Psychologist | 9860 Sw Hall Blvd Ste B, Tigard, OR 97223 | 2018-07-03 |
| 1043717390 | Rayna Donnelly | Physician Assistant | 9735 Sw Shady Ln Ste 102, Tigard, OR 97223 | 2018-04-11 |
| 1376059725 | Kaylie Marilyn Reyes | Behavioral Analyst | 9115 Sw Oleson Road, Portland, OR 97223 | 2017-12-21 |
| 1841704004 | Kathleen Terrell Taylor | Occupational Therapist | 7320 Sw Hunziker, Suite 203, Tigard, OR 97223 | 2017-11-27 |
| 1487163036 | Susie Riess | Counselor | 10763 Sw Greenburg Road, Suite 100, Tigard, OR 97223 | 2017-09-27 |
| 1043731243 | Tam Nguyen | Optometrist | 8795 Sw Scholls Ferry Rd Ste 100, Tigard, OR 97223 | 2017-06-28 |
| Find all providers in zip 97223 | ||||
| Taxonomy Code | 111N00000X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295392405 | Jessica Hudson | Chiropractor | 7360 Sw Hunziker Rd Ste 203, Tigard, OR 97223-2306 | 2019-05-22 |
| 1083102867 | Jennifer Collene Simons | Chiropractor | 11481 Sw Hall Blvd Ste 101, Tigard, OR 97223-8403 | 2018-04-26 |
| 1235640277 | Dan Minh Truong | Chiropractor | 9900 Sw Greenburg Rd Ste 185, Tigard, OR 97223-5405 | 2017-10-17 |
| 1144601451 | Daniel Mackay | Chiropractor | 7430 Sw Cherry Dr, Tigard, OR 97223-8041 | 2015-06-11 |
| 1881031334 | Elevation Chiropractic and Rehabilitation | Chiropractor | 9370 Sw Greenburg Rd Ste 605, Tigard, OR 97223-5442 | 2013-05-23 |
| 1073885166 | John Carlson | Chiropractor | 10260 Sw Greenburg Rd Ste 414, Tigard, OR 97223-5500 | 2012-02-03 |
| 1609189513 | Justin Michael Davis | Chiropractor | 9370 Sw Greenburg Rd # 605, Tigard, OR 97223-5442 | 2010-07-20 |
| 1225363419 | Daniel Burnett | Chiropractor | 12725 Sw 66th Ave Ste 205, Tigard, OR 97223-2548 | 2009-10-06 |
| 1598993073 | James J Lybarger | Chiropractor | 8861 Sw Commercial St, Tigard, OR 97223 | 2009-06-23 |
| 1801047733 | Jeffery S Hawkins | Chiropractor | 8900 Sw Omara St, Tigard, OR 97223-6005 | 2008-10-09 |
| Find all providers in TIGARD | ||||
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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.