- Practice location
- 12725 SW 66TH Ave Ste 205, Tigard, OR 97223-2548
- Phone
- 971-245-5699
- Fax
- —
- Last updated
- April 3, 2023
Kelly Alysa Bennett is a Massage Therapist based in Tigard, OR. Kelly Alysa Bennett practices in Tigard, OR and has the professional credentials of LMT, BCTMB. The NPI Number for Kelly Alysa Bennett is 1437854213 and holds a License No. 26594 (OR). The current practice location address for Kelly Alysa Bennett is 12725 SW 66TH Ave Ste 205, Tigard, OR 97223-2548 and can be reached out via phone at 971-245-5699.
Provider Profile Details
- NPI Number
- 1437854213
- Provider Name
- Kelly Alysa Bennett
- Credential
- LMT, BCTMB
- Provider Entity Type
- Individual
- Gender
- Female
- Address
- 12725 SW 66TH Ave Ste 205, Tigard, OR 97223-2548
- Phone Number
- 971-245-5699
- Primary Taxonomy
- Massage Therapist · 225700000X
- Sole Proprietor
- No
- Provider Enumeration Date
- April 3, 2023
- Last Update Date
- April 3, 2023
- Certification Date
- April 2, 2023
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 12725 SW 66TH Ave Ste 205
Tigard, OR 97223-2548 - City
- Tigard
- State
- Oregon
- Zip
- 97223-2548
- Phone Number
- 971-245-5699
Provider Business Mailing Address Details
- Address
- 15390 SW Kenton Dr
Tigard, OR 97224-7371 - City
- Tigard
- State
- OR
- Zip
- 97224-7371
- Phone Number
- 503-639-8768
License Information
- License Number
- 26594
- License State
- OR
- Taxonomy
- Massage Therapist · 225700000X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of Kelly A Bennett, LMT, BCTMB?
The NPI number of Kelly A Bennett, LMT, BCTMB is 1437854213. It was assigned on April 3, 2023 and is currently active in the NPPES registry.
What is the specialty of Kelly A Bennett, LMT, BCTMB?
Kelly A Bennett, LMT, BCTMB is registered under the primary taxonomy Massage Therapist (code 225700000X), licensed in OR under license number 26594.
Where does Kelly A Bennett, LMT, BCTMB practice?
The practice location is 12725 SW 66TH Ave Ste 205, Tigard, OR 97223-2548. The office can be reached at 971-245-5699 (phone).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1437854213 directly on the NPPES registry website.