Kelsie Ann Adamo
Individual provider Active NPI Massage Therapist · Bend, OR
NPI 1114738093 · NPPES record last updated Jan 23, 2025
Key facts
- NPI
- 1114738093
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Massage Therapist 225700000X
- License
- 22028 (OR)
- Practice address
- 999 SW Disk Dr Ste 105
Bend, OR 97702-3060 - Phone
- (541) 639-8911
- NPI assigned
- Jan 18, 2025
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
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 |
|---|---|---|---|
| 22028 | OR | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Heal Grow Thrive Medicine LLC | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 22028 | OR | Yes |
Addresses
Primary practice location
999 SW Disk Dr Ste 105
Bend, OR 97702-3060
Mailing address
999 SW Disk Dr Ste 105
Bend, OR 97702-3060
Other providers in Bend, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 23, 2025. 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.