KENNETH DANIEL FULLER
Massage Therapist

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

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
Gender Male
Credential LMT
Practice Address 9112 N Polk Ave
Portland
OR 97203-2320
Practice Telephone 5036606154
Mailing Address 9112 N Polk Ave
Portland
OR 97203-2320
Mailing Telephone 5036606154
Certification Date 2020-07-02
Enumeration Date 2020-07-02
Last Update Date 2020-07-02
Is Sole Proprietor N

Taxonomy

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

Office Location

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

Providers in the same zip code prefix

NPI Name Taxonomy Address Enumeration
1548781206 Pearce Engelder Pharmacist - Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 9000 N Lombard St, Portland, OR 97203 2017-07-03
1689705063 Diane Mae Feldt Social Worker 5139 N. Lombard Avenue, Portland, OR 97203 2007-03-08
1467639906 Scott Ellis Counselor - Mental Health 7621 N Portsmouth, Portland, OR 97203 2008-01-28
1043320880 Carol Jean Simmons · Carol Jean Rempel Nurse Practitioner - Family 5941 N Central, Portland, OR 97203 2006-08-30
1275879363 Matthew Scott Bennett Pharmacist 6850 N. Lombard, Portland, OR 97203 2012-12-18
1700103546 Lisa Catherine Davis Acupuncturist 1614 Ne Alberta Street, Portland, OR 97203 2010-05-03
1710172267 St Johns Dental Arts PC Dentist - General Practice 8407 N Lombard, Portland, OR 97203 2007-09-07
1497836621 Ingrid Daniela Schlechter-Keenan Physician Assistant 900 N Lombard Street, Portland, OR 97203 2006-10-17
1235320409 Valerie Alaina Poindexter Speech-Language Pathologist 8602 N Druid Ave, Portland, OR 97203 2007-08-05
1407335045 Gage Solis Student in an Organized Health Care Education/Training Program 8425 N. Lombard St, Portland, OR 97203 2018-08-13
Find all 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
1548831530 Fernando Stockfelt Massage Therapist 1710 Ne Multnomah St Apt 233, Portland, OR 97232-3648 2021-07-09
1790356715 Sarah E Stanton Massage Therapist 1615 Nw 23rd Ave Ste 2, Portland, OR 97210-2563 2021-07-09
1932770633 Kimberly Andrade Massage Therapist 425 Se 3rd Ave Ste 209, Portland, OR 97214-1039 2021-07-05
1760053458 Kerrie Doran Massage Therapist 6040 Se Belmont St Ste 1230, Portland, OR 97215-1974 2021-07-05
1023687787 Elizaveta S. Yufereva Massage Therapist 2311 E Burnside St, Portland, OR 97214-2576 2021-06-17
1093381519 Sandra N Coggins Massage Therapist 2306 Ne Glisan St Ste 203, Portland, OR 97232-2392 2021-06-03
1174199012 Emily M Reed · Emily M Williamson Massage Therapist 6802 Sw Canyon Rd, Portland, OR 97225-3613 2021-06-01
1659947992 Ashley Marie Nelson Massage Therapist 6634 Ne Alameda St, Portland, OR 97213-4657 2021-05-27
1649845157 Ninesha V Myers Massage Therapist 12110 E Burnside St Apt 111, Portland, OR 97216-3792 2021-05-26
1326613134 Francesca Cecilia Chabot Massage Therapist 2100 Ne Broadway St Ste 101, Portland, OR 97232-1500 2021-05-24
Find all providers in PORTLAND

Competitor

Search similar providers

City PORTLAND
Zip Code 97203

Providers with similar names

NPI Name Taxonomy Address Enumeration
1831775121 Kenneth Fuller Community Health Worker 3588 Nickel Plate Rd, Huntington, WV 25702-2158 2021-03-18
1447587381 Lucile Martin Fuller · Marti Shaw Fuller Speech-Language Pathologist 133 Settlers Ln, Kure Beach, NC 28449-3943 2009-11-13
1477122539 Okeysolom Kenneth Oradiegwu Jr. · Keso Kenneth Oradiegwu Jr. Dentist - General Practice 5601 Wesley St Ste A, Greenville, TX 75402-6320 2021-06-23
1013595636 Amy Fuller 6915 Brimstone Ln, Fairfax Station, VA 22039-1818 2021-04-02
1275107286 Joe Fuller Social Worker - Clinical 555 Sky Valley Camp Rd, Hendersonville, NC 28739-9426 2021-05-14
1982270088 Jalisa Fuller Driver 1621 Williamsburg Dr, Bossier City, LA 71112-3165 2021-05-28
1750978821 Valerie Fuller In Home Supportive Care 1691 Valley Dr, Marysville, OH 43040-8617 2020-12-23
1558935429 Tammy Fuller Home Health Aide 43 Horseshoe Bnd, Horace, ND 58047-5718 2021-05-16
1528453420 Katherine Fuller Student in an Organized Health Care Education/Training Program 750 W Ashby Rd, Brierfield, AL 35035-3437 2015-03-30
1982298139 Donte Fuller Community Health Worker 25 Sand Fork Rd, Linn, WV 26384-8235 2021-02-26

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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.