Kelly Selis, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

L3485 Issued in OR

Legal business name

KELLY SELIS, LCSW

Practice address

1715 E. Burnside St.
Portland, OR 97214

Phone

(503) 502-0208

NPI assigned

Oct 20, 2011

Organization subpart

No

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

Authorized official

Name

Kelly Selis

Title

Psychotherapist

Phone

(503) 502-0208

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1319068800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1319068800000",
    "number": "1841575974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1715 E. BURNSIDE ST.",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1715 E. BURNSIDE ST.",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97214",
            "telephone_number": "503-502-0208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KELLY SELIS, LCSW",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-20",
        "last_updated": "2011-10-20",
        "status": "A",
        "authorized_official_last_name": "SELIS",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "PSYCHOTHERAPIST",
        "authorized_official_telephone_number": "503-502-0208"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L3485",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jordi X Kellogg, MD
• Katie Kellogg
• Marissa Anne Kellogg, MD, MPH
• Kelly Prill Naturopathic Physcian, LLC
• Kelly Raylinsky
• Kelly Washburn, Inc.
• Kirsten Kelly-Chambers
• Nancy Kelly-Culberson, CRNA
• Amy Kelly
• Anabel Elizabeth Kelly, RN

• Clinical Social Worker in Portland, OR
• Providers in Portland, OR by specialty
• Clinical Social Worker in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2011; 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.