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Contact Information

CAROL L KELLY
1939 SW TROON AVE
BEND, OR97702
 Phone: 503-468-8757
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Occupational Therapy Assistant

224Z00000X
Indicates primary specialty

NPI Profile & details for CAROL L KELLY · (Female)

NPI # 1699900464
Status Active
Credentials
Entity Individual
Enumeration date 05/22/2009
Last updated 12/12/2018 - About 7 years ago
Sole proprietor 1 No
Identifiers
  • OR License # 412866
  • WA License # OC60159972
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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