Kelsey Bostwick, LMT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

22713 Issued in OR

Practice address

3430 SE Belmont St
Portland, OR 97214-4247

Phone

(503) 936-0104

NPI assigned

Dec 6, 2022

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Kabe Jennae Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1670284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670284800000",
    "number": "1972214385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5125 NE CLEVELAND AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972112611",
            "telephone_number": "503-936-0104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3430 SE BELMONT ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972144247",
            "telephone_number": "503-936-0104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOSTWICK",
        "first_name": "KELSEY",
        "credential": "LMT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-06",
        "last_updated": "2022-12-06",
        "certification_date": "2022-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "OR",
            "license": "22713",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KABE",
            "last_name": "JENNAE",
            "credential": "LMT",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Philip Boss
• Abigail L. Bossart, MD
• Amanda C Bossert, LPC
• Miranda Reshae Bostic, PMHNP-BC
• Bruce Alan Boston, MD
• Courtney Nicole Boswell
• Jennifer Botelho, PA-C
• Both-and Counseling
• Bryce Bothwell, DMD
• Lana Botney

• Massage Therapist in Portland, OR
• Providers in Portland, OR by specialty
• Massage Therapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 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.