Individual
MELINDA KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
15962 BOONES FERRY RD STE 202, LAKE OSWEGO, OR 97035-4360
(503) 860-2372
Mailing address
15962 BOONES FERRY RD STE 202, LAKE OSWEGO, OR 97035-4360
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
20680
OR
Other
Enumeration date
03/14/2015
Last updated
03/14/2015
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