Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Kelly Elizabeth Jackson, PT, DPT

Individual provider Orthopedic Physical Therapist · NPI 1053830968

Kelly Elizabeth Jackson, PT, DPT is a Physical Therapist in Private Practice in Clackamas, Oregon. Qualified in 2017, 9 years ago. Practices with Oregon Luna Care Physical Therapy LLC, a 52-clinician group and accepts Medicare assignment. Licensed in Oregon.

Years since qualifying
9
Licensed in
OR
In the registry since
2017
What do these letters mean?
PT — Physical Therapist
A licensed therapist who treats movement, pain and injury.
DPT — Doctor of Physical Therapy
The doctoral degree now required to enter physical therapy practice.

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Practice location Address checks out

10100 SE Sunnyside Rd
Clackamas, OR 97015-8970
Phone: (503) 813-2000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Orthopedic Physical Therapist (primary) Taxonomy 2251X0800X · Licence 62508 (OR)

Record details

NPI number1053830968
Entity typeIndividual (Type 1)
GenderFemale
Credentials PT , DPT
Sole proprietorNo
NPI enumeratedSeptember 12, 2017
Last updated in NPPESMarch 5, 2025
Certification dateMarch 5, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice Oregon Luna Care Physical Therapy Llc — 52 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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