Provider Demographics
NPI:1255202602
Name:HORTON, KAILEE (DPT, PT)
Entity type:Individual
Prefix:
First Name:KAILEE
Middle Name:
Last Name:HORTON
Suffix:
Gender:F
Credentials:DPT, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3400 STATE ST STE G780
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97301-7015
Mailing Address - Country:US
Mailing Address - Phone:503-391-5542
Mailing Address - Fax:503-391-5695
Practice Address - Street 1:1594 EDGEWATER ST NW STE 140
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97304-4600
Practice Address - Country:US
Practice Address - Phone:503-391-5542
Practice Address - Fax:503-391-5695
Is Sole Proprietor?:No
Enumeration Date:2025-09-17
Last Update Date:2025-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR65860225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist