MEDICARE: AVERY KELLEM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1184575987
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AVERY KELLEM

Provider Business Mailing Address
First Line	:	7108 S KANNER HWY
Second Line	:
City	:	STUART
State	:	FL
Zip	:	34997-7462
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	36 BOARDMAN ST
Second Line	:	#209
City	:	MCMINNVILLE
State	:	OR
Zip	:	97128
Country	:	US
Telephone Number	:	253-677-0203
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/06/2026
Last Update Date	:	02/06/2026

Similar Medicare Providers

1609490267 — GRACE ANNE CHAMBERLAIN
Practice Location Address:

115 NE MAY LN
MCMINNVILLE, OR
97128-9272

Practice Phone: 503-472-1338
Practice Fax:

1881697787 — DR. RICHARD I ECKER M.D.
Practice Location Address:

706 NE EVANS ST
MCMINNVILLE, OR
97128-3926

Practice Phone: 503-472-1405
Practice Fax: 503-434-5950

1568466282 — DR. DAVID FINK PFENDLER MD
Practice Location Address:

15410 NW BAKER CREEK RD
MCMINNVILLE, OR
97128-8063

Practice Phone: 503-472-4355
Practice Fax:

1417951849 — DR. RICHARD K KIMANI M.D.
Practice Location Address:

254 NE NORTON LN
MCMINNVILLE, OR
97128-8470

Practice Phone: 503-472-9002
Practice Fax: 503-474-0157

1477558807 — BEATA ANASZ-KOPECKA M.D.
Practice Location Address:

375 SE NORTON LN , STE A
MCMINNVILLE, OR
97128-8484

Practice Phone: 503-472-9002
Practice Fax: 503-474-0157

1194720524 — DR. ERIK E SWENSSON M.D.
Practice Location Address:

392 NE NORTON LN
MCMINNVILLE, OR
97128-8481

Practice Phone: 503-434-6060
Practice Fax: 503-435-6463

Directions to “ AVERY KELLEM ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.