Provider Demographics
NPI:1437620929
Name:VEERKAMP, KYLEE JO (LMT)
Entity Type:Individual
Prefix:
First Name:KYLEE
Middle Name:JO
Last Name:VEERKAMP
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:650 MARION ST NE APT 4A
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97301-3750
Mailing Address - Country:US
Mailing Address - Phone:208-860-6001
Mailing Address - Fax:971-275-1900
Practice Address - Street 1:223 COMMERCIAL ST NE STE 109
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97301-3411
Practice Address - Country:US
Practice Address - Phone:971-290-4376
Practice Address - Fax:971-275-1900
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-10
Last Update Date:2022-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR24712225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist