Independent US Healthcare Provider Directory & Public Medical Database
Deactivated NPI 1861714065 Deactivated / Inactive NPI Female Practitioner

Dr. Katie Evans Kelley , PhD, CDP, RC, NCACII

Counselor • Beaverton, OR

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Katie Kelley has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date February 16, 2010
NPI Deactivation Date May 24, 2023
Total Practice Duration ~13 Years of Practice (2010 – 2023)

Professional Overview & Biography Verified Profile Summary

Dr. Katie Kelley, PhD, CDP, RC, NCACII was a registered Counselor practicing in Beaverton, OR. Throughout an active medical career spanning 13 years, Dr. Kelley provided care at the practice location at 19943 SW JETTE LN until profile deactivation on 2023-05-24.

Practice Location & Contact Primary Location

Practice Address

19943 Sw Jette Ln

Beaverton, OR 970062789

Telephone 5037566117
Fax 5035243778
Associated Practice Facility / Clinic
🏢 Dr Katie Evans Inc Facility NPI 1255500203

Specialty Benchmarks & Practice Insights

Comparative analytics for Counselor in Beaverton, OR

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 14.0 Yrs
State Avg: 12.6 Yrs
Regional Practice Density
102 Specialists

Practicing in Beaverton, OR (4551 Statewide)

Telehealth Adoption Rate
1.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Counselor Primary Specialty

NUCC Taxonomy Code: 101Y00000X

State License WA RC00048071

A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated May 24, 2023

Record deactivated on May 24, 2023

NPI Profile Active February 16, 2010

NPI status registered as active in NPPES database

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Updated Practice Location February 16, 2010

Registered at 19943 SW JETTE LN, BEAVERTON, OR 970062789 (Tel: 5037566117)

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Updated Business Mailing Address February 16, 2010

Registered at 19943 SW JETTE LN, BEAVERTON, OR 970062789 (Tel: 5037566117)

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Provider Name / Credentials Updated February 16, 2010

Recorded as KATIE KELLEY, PHD, CDP, RC, NCACII

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Medical Taxonomy / Specialty Registered (Primary Specialty) February 16, 2010

Counselor (License #RC00048071 in WA)

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Initial NPI Registration & Enumeration February 16, 2010

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1861714065
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: February 16, 2010
Last Update: February 16, 2010
Deactivation Date: May 24, 2023

Mailing Address

19943 Sw Jette Ln

Beaverton, OR 970062789

Phone: 5037566117

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.