Provider Demographics
NPI:1407282452
Name:ARME, KELLY (LMT)
Entity Type:Individual
Prefix:
First Name:KELLY
Middle Name:
Last Name:ARME
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:KELLY
Other - Middle Name:
Other - Last Name:NORDAHL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2043 SE 50TH AVE UNIT B
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97215-3852
Mailing Address - Country:US
Mailing Address - Phone:503-609-0422
Mailing Address - Fax:
Practice Address - Street 1:2043 SE 50TH AVE UNIT B
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97215-3852
Practice Address - Country:US
Practice Address - Phone:503-609-0422
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-23
Last Update Date:2022-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR19818225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist