Provider Demographics
NPI:1538460035
Name:HAMMOND, KAYLA (LMT)
Entity Type:Individual
Prefix:MS
First Name:KAYLA
Middle Name:
Last Name:HAMMOND
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 1:445 HIGH ST SE
Mailing Address - Street 2:#200
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97301-4390
Mailing Address - Country:US
Mailing Address - Phone:503-269-4098
Mailing Address - Fax:
Practice Address - Street 1:445 HIGH ST SE
Practice Address - Street 2:#200
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97301-4390
Practice Address - Country:US
Practice Address - Phone:503-269-4098
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-15
Last Update Date:2010-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR14920225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist