Provider Demographics
NPI:1225871817
Name:HARNAR, KELSEY RYAN (DPT)
Entity type:Individual
Prefix:DR
First Name:KELSEY
Middle Name:RYAN
Last Name:HARNAR
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:457 S CENTER ST
Mailing Address - Street 2:
Mailing Address - City:OREGON CITY
Mailing Address - State:OR
Mailing Address - Zip Code:97045-2948
Mailing Address - Country:US
Mailing Address - Phone:971-998-4667
Mailing Address - Fax:
Practice Address - Street 1:501 N DIXON ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97227-1876
Practice Address - Country:US
Practice Address - Phone:503-916-6051
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-13
Last Update Date:2024-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR63757225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist