Kevin Allen Jarvis, D.P.T

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

61807 Issued in OR

Practice address

17550 Provost St Ste 201a
Lake Oswego, OR 97034-5220

Phone

(503) 872-2441

NPI assigned

Aug 31, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Specialty

Physical Therapist in Private Practice

Education

Other, 2016

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Providence Health & Services Oregon

  • General Practice Physician
  • Lake Oswego, OR
  • NPI 1023488343
  NPD
• Active Edge Physical Therapy, LLC

  • Orthopedic Physical Therapist
  • Oregon City, OR
  • NPI 1043685068
  NPD (past)
• Active Edge Physical Therapy, LLC

  • Orthopedic Physical Therapist
  • Oregon City, OR
  • NPI 1134584774
  NPD (past)

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

{
    "created_epoch": "1472601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755993600000",
    "number": "1306392147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31001-4180",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911104180",
            "telephone_number": "503-215-6494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17550 PROVOST ST STE 201A",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970345220",
            "telephone_number": "503-872-2441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JARVIS",
        "first_name": "KEVIN",
        "middle_name": "ALLEN",
        "credential": "D.P.T",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-08-31",
        "last_updated": "2025-08-24",
        "certification_date": "2025-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "61807",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Janice M. Johnson Counseling
• Janice Modesitt LMT
• Mark Stephen Jardini, MD
• Alexis Jarmer
• Corinne Jarvis, M.S., CCC-SLP
• Anika Lee Jatho
• Justin Ryan Jelen, D.C.
• Deniese Elaine Jensen Granville, DPM
• Anita Jensen, MS, CCC-SLP
• Tabitha Alana Jensen

• All providers in Lake Oswego, OR
• Physical Therapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.