Kelly Mary Baltazar, N.D., D.C.

Primary specialty

NaturopathTaxonomy code 175F00000X

License

4063 Issued in OR

Practice address

3025 SW Corbett Ave
Portland, OR 97201-4858

Phone

(503) 552-1551

Fax

(503) 226-8133

NPI assigned

Jul 3, 2007

Sex

Female

Sole proprietor

Yes

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

State licenses

Practice roles

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.

• National University of Natural Medicine

  • Student in an Organized Health Care Education/Training Program
  • Portland, OR
  • NPI 1730301250
  NPD (past)

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

{
    "created_epoch": "1183420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1669670550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7425 SW ALOMA WAY APT 1",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972237919",
            "telephone_number": "425-269-8187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3025 SW CORBETT AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972014858",
            "telephone_number": "503-552-1551",
            "fax_number": "503-226-8133"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5331 SW MacAdam Ave Ste 380",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972393879",
            "country_code": "US",
            "telephone_number": "503-552-1551",
            "fax_number": "503-226-8133",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BALTAZAR",
        "first_name": "KELLY",
        "middle_name": "MARY",
        "name_prefix": "Dr.",
        "credential": "N.D., D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-07-03",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OR",
            "license": "5843",
            "primary": false
        },
        {
            "code": "175F00000X",
            "taxonomy_group": "",
            "desc": "Naturopath",
            "state": "OR",
            "license": "4063",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard Marion Balsiger Jr., D.C.
• Katharine S Balske
• Aubrey Balster, ND
• Danielle Balsz, R.N.
• Denisse Baltazar Molinar
• Oleg Balter, MD
• Bill-Bern Balthazard
• Kyle Matthew Baltrusch, MD
• Ellen Scott Baltus, LCSW
• Julianne Baltzley

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.