Adelia Ketchum, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

Practice address

9100 SE Sunnyside Rd
Clackamas, OR 97015-6772

Phone

(503) 305-6129

NPI assigned

Sep 11, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Addie Ketchum Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1599782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599782400000",
    "number": "1265047724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2936 SE MONROE ST",
            "city": "MILWAUKIE",
            "state": "OR",
            "postal_code": "972226635",
            "telephone_number": "503-407-5927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9100 SE SUNNYSIDE RD",
            "city": "CLACKAMAS",
            "state": "OR",
            "postal_code": "970156772",
            "telephone_number": "503-305-6129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KETCHUM",
        "first_name": "ADELIA",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-11",
        "last_updated": "2020-09-11",
        "certification_date": "2020-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ADDIE",
            "last_name": "KETCHUM",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Erin Elizabeth Kent
• Stephen Keresztes
• Freda Kerman, M.D.
• Katelynn Kern
• Michelle Lynn Kerron
• Emily Marie Ketola, LCSW
• Muhammad Farhan Khaliq, M.D.
• Yiichiang XXX Khan, M.D.
• Stephanie Khouw, NP
• Christian A Killer, MD

• Physical Therapist in Clackamas, OR
• Providers in Clackamas, OR by specialty
• Physical Therapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2020; 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.