Kelley S. Fellman, MD

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

MD25861 Issued in OR

Practice address

3415 SE Powell Blvd
Portland, OR 97202-3371

Phone

(503) 234-9591

NPI assigned

Jul 24, 2006

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1238025600000",
    "number": "1568484103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6115 NE 30TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972116735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3415 SE POWELL BLVD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972023371",
            "telephone_number": "503-234-9591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FELLMAN",
        "first_name": "KELLEY",
        "middle_name": "S.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-24",
        "last_updated": "2009-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "OR",
            "license": "MD25861",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Margi Marie Felix
• Jeff S Felker, D.C.
• Kellie Faye Fellen
• Nicole Fellenz, LPC, ATR
• Eric Ryan Fellin
• Fellow Travelers Counseling, LLC
• Fellows Alf Operations LLC
• Haley Anne Fellows
• Rhiannon Fellure
• Kathryn Felmet, MD

• Child & Adolescent Psychiatry Physician in Portland, OR
• Providers in Portland, OR by specialty
• Child & Adolescent Psychiatry Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2009; 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.