Kaleb Micheal Welch, LMT
Individual provider Active NPI Massage Therapist · Hubbard, OR
NPI 1093259376 · NPPES record last updated Dec 6, 2016
Key facts
- NPI
- 1093259376
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Massage Therapist 225700000X
- License
- 22906 (OR)
- Practice address
- 17707 Front St NE
Hubbard, OR 97032-9702 - Phone
- (971) 227-0014
- Fax
- (267) 430-5571
- NPI assigned
- Dec 6, 2016
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22906 | OR | MD | Massage Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 22906 | OR | Yes |
Addresses
Primary practice location
17707 Front St NE
Hubbard, OR 97032-9702
Mailing address
17707 Front St NE
Hubbard, OR 97032-9702
Phone (971) 227-0014
Other providers in Hubbard, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 6, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.