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Randall Kelly, MHS, DMSC, PA-C

NPI 1922393974 · on the registry since 2011

Practice

Address
256 E Hurlburt Ave Ste 117
Hermiston, OR 97838
Phone
(541) 303-3558
Fax
(509) 593-4644
Organisation at this address
Perfectly Broken Llc
New Life Wellness Llc
Inferred from a shared address, not stated in the registry.
Clinicians at this address
4

Additional practice sites

  • 278 E High St Ste 209, Stayton, OR
  • 71 Centennial Loop Ste A, Eugene, OR
  • 761 Main St, Dallas, OR
  • 1901 Garden Ave Ste 210, Eugene, OR
  • 2900 Nw Clearwater Dr, Bend, OR
  • 1817 Ne 6th Ave, Portland, OR
  • 1110 Se Alder St Ste 301, Portland, OR
  • 4909 S Coast Hwy Ste 1k, South Beach, OR
  • 124 W Kennewick Ave Ste 11, Kennewick, WA
  • 520 Nw 4th St, Corvallis, OR
  • 1345 Nw 15th St, Lincoln City, OR

Registry record

Primary taxonomy
363A00000X
363A00000X
Also registered as
101YA0400X
363AM0700X
2083A0300X
363A00000X
2083A0300X
Licence states on file
OR, WA
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2026-03-27

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Oregon