Active NPI
Lacey Elizabeth Rose Klem, LMT
- Massage Therapist
- Milton Freewater, OR
National Provider Identifier
1356812192
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 24742
- Practice address
- 85458 Hywy 11
Milton Freewater, OR 97862 - Phone
- (541) 938-8300
- Fax
- (541) 938-3924
- NPI assigned
- Dec 5, 2018
- Last updated
- Dec 5, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 24742 | OR | Primary |
Addresses
Primary practice location
85458 Hywy 11
Milton Freewater, OR 97862
Mailing address
85458 Hywy 11
Milton Freewater, OR 97862
Phone (541) 938-8300
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 24742 | OR | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| K. C. Chiropractic LLC | Past | Accepting new patients | |
| Amon Chiropractic LLC | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1543968000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1543968000000",
"number": "1356812192",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "85458 HYWY 11",
"city": "MILTON FREEWATER",
"state": "OR",
"postal_code": "97862",
"telephone_number": "541-938-8300",
"fax_number": "541-938-3924"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "85458 HYWY 11",
"city": "MILTON FREEWATER",
"state": "OR",
"postal_code": "97862",
"telephone_number": "541-938-8300",
"fax_number": "541-938-3924"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KLEM",
"first_name": "LACEY",
"middle_name": "ELIZABETH ROSE",
"name_prefix": "Ms.",
"credential": "LMT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-12-05",
"last_updated": "2018-12-05",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "OR",
"license": "24742",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Milton Freewater, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 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.