Kelley Marie Henry, DC, PHD, LMT, HFS

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

5893 Issued in OR

Practice address

2600 NW Vaughn St
Portland, OR 97210-2224

Phone

(508) 864-1056

NPI assigned

Feb 19, 2013

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Networks

• WA PPO C-SNP
• devoted network organization-83621310-88c0-4660-8f8d-b8ea8f4dc04e

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Fuel Spine & Sports Therapy

  • Chiropractor
  • Seattle, WA
  • NPI 1548647498
  NPD (past)
• Seattle Sports Chiropractic & Physical Therapy

  • Sports Physician Chiropractor
  • Seattle, WA
  • NPI 1932888518

  Massage Therapist

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1361232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519430400000",
    "number": "1013257682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2465 NW RALEIGH ST",
            "address_2": "APT. 107",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972102648",
            "telephone_number": "508-864-1056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 NW VAUGHN ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972102224",
            "telephone_number": "508-864-1056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENRY",
        "first_name": "KELLEY",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "DC, PHD, LMT, HFS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-02-19",
        "last_updated": "2018-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "OR",
            "license": "18150",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OR",
            "license": "5893",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Clifford Chepo Nathaniel Henry
• Gary James Henry
• James A Henry, PH.D.
• James Edgar Henry, RESIDENTAL COUNSELOR
• Julie Jackson Henry, RPH
• Lacey Jo Henry, PHARM. D.
• Linda Henry, QMHA
• Lisa Diane Henry
• Lori Henry
• Mark Henry, LPC

• Chiropractor in Portland, OR
• Providers in Portland, OR by specialty
• Chiropractor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.