Active NPI
Kristen Marie Kelly, ND
- Naturopath
- Portland, OR
National Provider Identifier
1699344671
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Naturopath
- License
- 4400
- Practice address
- 2005 SE Hawthorne Blvd
Portland, OR 97214-3819 - Phone
- (503) 236-4580
- Fax
- (503) 231-8400
- NPI assigned
- Jun 23, 2021
- 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 |
|---|---|---|---|---|
| Naturopath | 175F00000X | 4400 | OR | Primary |
Addresses
Primary practice location
2005 SE Hawthorne Blvd
Portland, OR 97214-3819
Mailing address
2005 SE Hawthorne Blvd
Portland, OR 97214-3819
Phone (503) 236-4580
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 |
|---|---|---|---|
| 4400 | OR | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| A Balanced Life Health Care | Past | Accepting new patients | |
| National University of Natural Medicine | 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 and National Provider Directory roles.
-
- Health Maintenance Organization
- Portland, OR
- NPI 1083040869
-
- Student in an Organized Health Care Education/Training Program
- Portland, OR
- NPI 1730301250
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1624406400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1778025600000",
"number": "1699344671",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2005 SE HAWTHORNE BLVD",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972143819",
"telephone_number": "503-236-4580",
"fax_number": "503-231-8400"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2005 SE HAWTHORNE BLVD",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972143819",
"telephone_number": "503-236-4580",
"fax_number": "503-231-8400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLY",
"first_name": "KRISTEN",
"middle_name": "MARIE",
"name_prefix": "Dr.",
"credential": "ND",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-06-23",
"last_updated": "2026-05-06",
"certification_date": "2026-05-06",
"status": "A"
},
"taxonomies": [
{
"code": "175F00000X",
"taxonomy_group": "",
"desc": "Naturopath",
"state": "OR",
"license": "4400",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.