KENNETH DANIEL FULLER

Address: 9112 N Polk Ave, Portland, OR 97203-2320
Phone: 5036606154

KENNETH DANIEL FULLER (NPI# 1326665670) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1326665670
Entity Type Individual
Full Name KENNETH DANIEL FULLER
Credential LMT
Practice Address 9112 N Polk Ave
Portland
OR 97203-2320
Practice Telephone 5036606154
Mailing Telephone 5036606154
Enumeration Date 2020-07-02
Last Update Date 2020-07-02
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 225700000X Massage Therapist 12913 OR Respiratory, Developmental, Rehabilitative and Restorative Service Providers

Other Providers KENNETH FULLER

NPI Name Taxonomy Address Enumeration
1184035198 Kenneth Fuller Jr. Occupational Therapy Assistant 106 S Beverly St, Perry, FL 32348-5122 2014-05-13
1538508163 Kenneth Michael Fuller Jr. Nurse Practitioner 518 Enchanted Hollow Dr, Spring, TX 77388-6108 2013-06-17
1851816755 Kenneth Leon Fuller Jr. Counselor 1965 Live Oak Blvd, Yuba City, CA 95991-8850 2017-08-11

Office Location

Street Address 9112 N POLK AVE
City PORTLAND
State OR
Zip Code 97203-2320

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1952923757 Justin Cummings Meals 10105 N. Oswego Ave, Portland, OR 97203 2020-05-14
1407335045 Gage Solis Student in an Organized Health Care Education/Training Program 8425 N. Lombard St, Portland, OR 97203 2018-08-13
1497103493 Ruby Diane Ciarlante Community Health Worker 7803 N Portsmouth Ave, Portland, OR 97203 2016-05-31
1992139620 Hannah Clare Speech-Language Pathologist 7126 N Amherst St, Portland, OR 97203 2013-08-29
1043656713 Heather Ranae Mcintosh Social Worker 7323 N Burlington Ave, Portland, OR 97203 2013-05-21
1275879363 Matthew Scott Bennett Pharmacist 6850 N. Lombard, Portland, OR 97203 2012-12-18
1144594094 Candice Juliet Thomas Pharmacist 9000 N. Lombard St, Portland, OR 97203 2012-02-23
1093013211 Aarisa Elysianne Smith Mechanotherapist 8438 N Lombard St, Ste 7, Portland, OR 97203 2011-03-11
1700103546 Lisa Catherine Davis Acupuncturist 1614 Ne Alberta Street, Portland, OR 97203 2010-05-03
1427298579 Donald Marvin Lorenzen Denturist 8530 N. Ivanhoe, Portland, OR 97203 2009-03-03
Find all providers in zip 97203

Taxonomy Information

Taxonomy Code 225700000X
Grouping Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Classification Massage Therapist

Taxonomy Definition

An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1063013712 Gabriel Henriques Massage Therapist 805 Se Peacock Ln, Portland, OR 97214-3278 2020-11-07
1871193490 Heather R Anderson Massage Therapist 1646 Se Tenino St, Portland, OR 97202-6713 2020-11-01
1205435716 Michella Onnis Massage Therapist 2410 Se 10th Ave, Portland, OR 97214-4624 2020-10-26
1063019479 Kevin Thomas Ryan Massage Therapist 2220 Nw Front Ave Apt 316, Portland, OR 97209-1998 2020-10-08
1497352389 Nikki Nesta Massage Therapist 7849 Se Monroe St, Portland, OR 97222-1158 2020-10-05
1518574953 Jessica Rose Hobbs Massage Therapist 1515 Sw Jefferson St Apt 15, Portland, OR 97201-6064 2020-09-29
1295340057 Shane Dylan Adair Massage Therapist 2934 Se Stephens St, Portland, OR 97214-4960 2020-09-09
1518579416 Scott Schwartz Massage Therapist 4425 S Corbett Ave, Portland, OR 97239-4260 2020-08-20
1134747074 Katrina Hubbard Massage Therapist 1515 Sw 5th Ave, Portland, OR 97201-5406 2020-07-07
1407474539 Kirstin Hoops Massage Therapist 1531 N Webster St, Portland, OR 97217-3752 2020-07-06
Find all providers in PORTLAND

Competitor

Search similar providers

City PORTLAND
Zip Code 97203

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.