Provider Demographics
NPI:1013236355
Name:KELLAR, KAREN L (RT)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:L
Last Name:KELLAR
Suffix:
Gender:F
Credentials:RT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16471 S UNION MILLS RD
Mailing Address - Street 2:
Mailing Address - City:MULINO
Mailing Address - State:OR
Mailing Address - Zip Code:97042-9715
Mailing Address - Country:US
Mailing Address - Phone:503-829-5922
Mailing Address - Fax:
Practice Address - Street 1:10180 SE SUNNYSIDE RD
Practice Address - Street 2:
Practice Address - City:CLACKAMAS
Practice Address - State:OR
Practice Address - Zip Code:97015-8970
Practice Address - Country:US
Practice Address - Phone:503-652-2880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-26
Last Update Date:2010-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR227800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Certified