Katherine Jane Kelly, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PY60563485 Issued in WA

Practice address

9040 Jackson Avenue
Tacoma, WA 98531

Phone

(425) 757-2920

NPI assigned

Aug 20, 2007

Last updated

Mar 13, 2019By 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 4

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

• Hope Psychology & Assessments

  dba Katherine J. Kelly, Ph.D.

  • Community/Behavioral Health Agency
  • Renton, WA
  • NPI 1457720351
  Authorized official Same address or phone

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

{
    "created_epoch": "1187568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552435200000",
    "number": "1841483286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14900 INTERURBAN AVE S STE 271",
            "city": "TUKWILA",
            "state": "WA",
            "postal_code": "981684654",
            "telephone_number": "425-757-2920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9040 JACKSON AVENUE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "98531",
            "telephone_number": "425-757-2920"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "314 W Richardson Cir",
            "address_purpose": "LOCATION",
            "city": "Hartsville",
            "state": "SC",
            "postal_code": "295505436",
            "country_code": "US",
            "telephone_number": "453-383-8040",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7040 Jackson Avenue Department Of Behavioral Health",
            "address_purpose": "LOCATION",
            "city": "Tacoma",
            "state": "WA",
            "postal_code": "984315436",
            "country_code": "US",
            "telephone_number": "425-757-2929",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELLY",
        "first_name": "KATHERINE",
        "middle_name": "JANE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-20",
        "last_updated": "2019-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "WA",
            "license": "PY60563485",
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "NC",
            "license": "102699",
            "primary": false
        },
        {
            "code": "103TH0100X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health Service",
            "state": "SC",
            "license": "1070",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WA",
            "license": "PY60563485",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1070",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hannah Rose Kelly
• Heidi Ann Kelly
• Ian Patrick Kelly, MD
• Jessica Kelly, MSW, LMSW
• Jessica Ellen Kelly, ARNP
• Kendra Dane Kelly
• Khadine Kelly
• Michael John Kelly, M.D.
• Michael Joseph Kelly, M.D.
• Ryan Kelly, DO

• Psychologist in Tacoma, WA
• Providers in Tacoma, WA by specialty
• Psychologist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2019; 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.