Organization
OFFICE OF INTEGRATIVE MEDICINE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JANET R KELLY MD (OWNER)
(503) 366-6244
Entity
Organization
Contact information
Practice address
525 N COLUMBIA RIVER HWY, SAINT HELENS, OR 97051-1226
(503) 366-6244
(503) 366-6246
Mailing address
PO BOX 976, SAINT HELENS, OR 97051-0976
(503) 366-6244
(503) 366-6246
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
125757
—
OR
01
—
865437000
BLUE CROSS
OR
Enumeration date
11/13/2006
Last updated
02/20/2009
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