Kellie Linn Connery, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT60914300 Issued in WA

Practice address

530 Bogachiel Way
Forks, WA 98331

Phone

(360) 374-6271

Fax

(360) 374-2520

NPI assigned

Oct 4, 2018

Last updated

Aug 21, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other names 1

• Kellie Linn Hansen Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1538611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724198400000",
    "number": "1013482132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 BOGACHIEL WAY",
            "city": "FORKS",
            "state": "WA",
            "postal_code": "98331",
            "telephone_number": "360-374-6271",
            "fax_number": "360-374-2520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 BOGACHIEL WAY",
            "city": "FORKS",
            "state": "WA",
            "postal_code": "98331",
            "telephone_number": "360-374-6271",
            "fax_number": "360-374-2520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNERY",
        "first_name": "KELLIE",
        "middle_name": "LINN",
        "name_prefix": "Mrs.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-04",
        "last_updated": "2024-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "62705",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT60914300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLIE",
            "last_name": "HANSEN",
            "middle_name": "LINN",
            "credential": "P.T.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Clallam County Public Hospital District No 1 (Forks Community Hospital)
• Clallam County Public Hospital District No 1 (West End Outreach Services)
• Clallam County Public Hospital District No 1 (Forks Community Hospital)
• Cathy A. Clark L.M.P., LIC. MASSAGE PRACTIT
• Concerned Citizens
• Kyle Connery, DPT
• Brendan Cooney
• Richard Lee Dickson, MD
• Family Medical Center of Forks, Inc, PS (Family Medical Center)
• Family Planning of Clallam County

• Physical Therapist in Forks, WA
• Providers in Forks, WA by specialty
• Physical Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.