Individual provider Active NPI

Kate Stelly Jelline, PHARM. D

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Clackamas, OR
National Provider Identifier
1982989562
Registry record updated Oct 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X
License
0011887 Issued in OR
Practice address
16000 SE Evelyn St
Clackamas, OR 97015-9519
Phone
(503) 657-6363
NPI assigned
Oct 14, 2011
Last updated
Oct 14, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 14, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X 0011887 OR Primary

Addresses

Primary practice location

16000 SE Evelyn St
Clackamas, OR 97015-9519

Mailing address

16000 SE Evelyn St
Clackamas, OR 97015-9519
Phone (503) 657-6363

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
0011887ORMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

NPI Registry JSON

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

{
    "created_epoch": "1318550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318550400000",
    "number": "1982989562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16000 SE EVELYN ST",
            "city": "CLACKAMAS",
            "state": "OR",
            "postal_code": "970159519",
            "telephone_number": "503-657-6363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16000 SE EVELYN ST",
            "city": "CLACKAMAS",
            "state": "OR",
            "postal_code": "970159519",
            "telephone_number": "503-657-6363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JELLINE",
        "first_name": "KATE",
        "middle_name": "STELLY",
        "name_prefix": "Dr.",
        "credential": "PHARM. D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-10-14",
        "last_updated": "2011-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "OR",
            "license": "0011887",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clackamas, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 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.