Healthcare Provider Details

I. General information

NPI: 1407282452
Provider Name (Legal Business Name): KELLY ARME LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KELLY NORDAHL

II. Dates (important events)

Enumeration Date: 09/23/2013
Last Update Date: 10/09/2026
Certification Date: 10/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9123 SE SAINT HELENS ST STE 275F
CLACKAMAS OR
97015-6801
US

IV. Provider business mailing address

9123 SE SAINT HELENS ST STE 275F
CLACKAMAS OR
97015-6801
US

V. Phone/Fax

Practice location:
  • Phone: 503-609-0422
  • Fax:
Mailing address:
  • Phone: 503-609-0422
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number19818
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: