KELLIE T WILSON (NPI# 1306982384) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306982384 |
| Entity Type | Individual |
| Full Name | KELLIE T WILSON |
| Credential | MPT |
| Practice Address |
18122 Sw Lower Boones Ferry Rd Tigard OR 97224-7216 |
| Practice Telephone | 5036392118 |
| Practice Fax Number | 5036397688 |
| Mailing Telephone | 5036392118 |
| Mailing Fax Number | 5036397688 |
| Enumeration Date | 2007-01-29 |
| Last Update Date | 2008-12-03 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | 3074 | OR | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | STATE OF OREGON LICENSE NUMBER | 3074 | 01 |
| WA | 207626 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275035339 | Kellie Wilson | Speech-Language Pathologist | 950 Wilson Hollow Way, Sevierville, TN 37876-8963 | 2018-03-05 |
| 1013370634 | Kellie R Wilson | Licensed Practical Nurse | 385 7th St, Manistee, MI 49660-1966 | 2016-03-31 |
| 1083886816 | Kellie Natasha Wilson | Speech-Language Pathologist | 15015 W Airport Blvd Apt 612, Sugar Land, TX 77478-7087 | 2008-04-01 |
| 1396258562 | Kellie Ann Wilson | Social Worker | 7010 S Yale Ave Ste 215, Tulsa, OK 74136-5743 | 2017-11-10 |
| 1982046934 | Kellie Wilson | Pharmacist | 201 E Park Ave, Anaconda, MT 59711-2340 | 2013-07-18 |
| Street Address |
18122 SW LOWER BOONES FERRY RD |
| City | TIGARD |
| State | OR |
| Zip Code | 97224-7216 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861424574 | Lisa Ann Freeman | Physical Therapist | 18122 Sw Lower Boones Ferry Rd, Tigard, OR 97224-7216 | 2006-07-06 |
| 1497278626 | Kindra Fish | Physical Therapist | 18122 Sw Lower Boones Ferry Rd, Tigard, OR 97224-7216 | 2017-07-19 |
| 1144671454 | Ernesto Marquez | Physical Therapist | 18122 Sw Lower Boones Ferry Rd, Tigard, OR 97224-7216 | 2016-06-28 |
| 1851767636 | Kirsten Gower | Physical Therapist | 18122 Sw Lower Boones Ferry Rd, Tigard, OR 97224-7216 | 2015-08-17 |
| 1386052207 | Anthony Braga | Physical Therapist | 18122 Sw Lower Boones Ferry Rd, Tigard, OR 97224-7216 | 2014-07-23 |
| 1285921148 | Chandrika M Bickford | Physical Therapist | 18122 Sw Lower Boones Ferry Rd, Tigard, OR 97224-7216 | 2011-06-29 |
| 1922244185 | Barbara Anne Clark | Physical Therapist | 18122 Sw Lower Boones Ferry Rd, Tigard, OR 97224-7216 | 2008-12-18 |
| 1871717611 | Walton Physical Therapy & Sports Medicine Inc | Clinic/Center | 18122 Sw Lower Boones Ferry Rd, Tigard, OR 97224-7216 | 2007-04-12 |
| 1649354226 | Emily Mckenna | Physical Therapist | 18122 Sw Lower Boones Ferry Rd, Tigard, OR 97224-7216 | 2006-10-24 |
| 1477637072 | Chase Katich | Physical Therapist | 18122 Sw Lower Boones Ferry Rd, Tigard, OR 97224-7216 | 2006-10-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154973139 | Katherine Raineri | Psychologist | 7213 Sw Hazel Fern Rd, Tigard, OR 97224 | 2019-07-10 |
| 1871064618 | Stacey A Wenzel | Speech-Language Pathologist | 17020 Sw Upper Boones Ferry Rd.,suite 201, Tigard, OR 97224 | 2018-12-05 |
| 1376010090 | Meredith Rae Brezinski | Physical Therapist | 18019 Sw Boones Ferry Road, Tigard, OR 97224 | 2018-10-31 |
| 1649759358 | Viktoriya A Chiliy | Behavior Technician | 15290 Sw Royalty Parkway, Tigard, OR 97224 | 2018-08-13 |
| 1609384866 | Rachel E King | Physical Therapist | 18040 Sw Lower Boones Ferry Rd Ste 200, Tigard, OR 97224 | 2018-01-22 |
| 1689190134 | Isabelle Cooper Klee Caballero | Speech-Language Pathologist | 17020 Sw Upper Boones Ferry Road Suite 201, Tigard, OR 97224 | 2017-08-16 |
| 1427573146 | Breanna M Sandefur | Behavior Technician | 15290 Sw Royalty Pkwy, Tigard, OR 97224 | 2017-08-03 |
| 1083141196 | Krista Espenship | Registered Nurse | 8032 Sw Ashford St, Tigard, OR 97224 | 2017-05-19 |
| 1275067928 | Emily Elizabeth Myers | Behavioral Analyst | 15290 Royalty Parkway, Tigard, OR 97224 | 2017-04-19 |
| 1235684937 | Melanie Salvador | Nurse Practitioner | 15352 Sw Oakmont Pl, Tigard, OR 97224 | 2016-08-23 |
| Find all providers in zip 97224 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659720050 | Jesseka Jean Collins I | Specialist | 14741 Sw 109th Avenue Apt 3, Tigard, OR 97224 | 2016-06-07 |
| 1194128579 | Kevin Dean Darnell I | Specialist | 7155 Sw Varns St, Suite 214, Tigard, OR 97223-8174 | 2014-09-30 |
| 1992113039 | Lacey Lee Holland | Specialist | 7440 Sw Hunziker St Ste B, Tigard, OR 97223-8243 | 2014-07-31 |
| 1528351236 | Ashley N Reagan | Specialist | 11565 Sw Durham Rd Ste 110, Tigard, OR 97224-3553 | 2011-05-27 |
| 1598058786 | Angelique Wise | Specialist | 14340 Sw 80th Pl, Tigard, OR 97224-8162 | 2011-05-20 |
| 1891025854 | Willamette Medical Labs, Inc. | Specialist | 9735 Sw Shady Ln Ste 203, Tigard, OR 97223-5481 | 2010-01-13 |
| 1710216353 | Robin C. Blakeslee Smith | Specialist | 12566 Sw Main St, Tigard, OR 97223-6129 | 2009-12-10 |
| 1649503475 | Ed F Schwartz | Specialist | 11930 Sw Greenbug Road, Tigard, OR 97223-6453 | 2009-09-11 |
| 1386873214 | Rich Hines | Specialist | 11515 Sw Durham Rd Ste E9, Tigard, OR 97224-3476 | 2009-07-14 |
| 1548403702 | Sonya M King | Specialist | 7505 Sw Crestview St, Tigard, OR 97223-8206 | 2009-04-16 |
| 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.