Individual
MS. KELLY ANN BAUMANN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
3806 SE BELMONT ST, PORTLAND, OR 97214-4330
(917) 679-4884
Mailing address
1005 SE 16TH AVE APT 2, PORTLAND, OR 97214-2665
(917) 679-4884
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
26972
OR
Other
Enumeration date
09/14/2022
Last updated
09/14/2022
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