KRISTINE MARIE PETROSYAN (NPI# 1083250591) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083250591 |
| Entity Type | Individual |
| Full Name | KRISTINE MARIE PETROSYAN |
| Credential | LMT |
| Practice Address |
11565 Sw Durham Rd Ste 110 Tigard OR 97224-3553 |
| Practice Telephone | 5036390778 |
| Practice Fax Number | 5036390815 |
| Mailing Telephone | 5036390778 |
| Mailing Fax Number | 5036390815 |
| Enumeration Date | 2019-11-19 |
| Last Update Date | 2019-11-19 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225700000X | Massage Therapist | 25518 | OR | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
11565 SW DURHAM RD STE 110 |
| City | TIGARD |
| State | OR |
| Zip Code | 97224-3553 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528351236 | Ashley N Reagan | Specialist | 11565 Sw Durham Rd Ste 110, Tigard, OR 97224-3553 | 2011-05-27 |
| 1578920674 | Kristin Nicole Cardoza | Massage Therapist | 11565 Sw Durham Rd Ste 110, Tigard, OR 97224-3553 | 2016-01-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154973139 | Katherine Raineri | Psychologist | 7213 Sw Hazel Fern Rd, Tigard, OR 97224 | 2019-07-10 |
| 1871064618 | Stacey A Wenzel | Speech-Language Pathologist | 17020 Sw Upper Boones Ferry Rd.,suite 201, Tigard, OR 97224 | 2018-12-05 |
| 1376010090 | Meredith Rae Brezinski | Physical Therapist | 18019 Sw Boones Ferry Road, Tigard, OR 97224 | 2018-10-31 |
| 1649759358 | Viktoriya A Chiliy | Behavior Technician | 15290 Sw Royalty Parkway, Tigard, OR 97224 | 2018-08-13 |
| 1609384866 | Rachel E King | Physical Therapist | 18040 Sw Lower Boones Ferry Rd Ste 200, Tigard, OR 97224 | 2018-01-22 |
| 1689190134 | Isabelle Cooper Klee Caballero | Speech-Language Pathologist | 17020 Sw Upper Boones Ferry Road Suite 201, Tigard, OR 97224 | 2017-08-16 |
| 1427573146 | Breanna M Sandefur | Behavior Technician | 15290 Sw Royalty Pkwy, Tigard, OR 97224 | 2017-08-03 |
| 1083141196 | Krista Espenship | Registered Nurse | 8032 Sw Ashford St, Tigard, OR 97224 | 2017-05-19 |
| 1275067928 | Emily Elizabeth Myers | Behavioral Analyst | 15290 Royalty Parkway, Tigard, OR 97224 | 2017-04-19 |
| 1235684937 | Melanie Salvador | Nurse Practitioner | 15352 Sw Oakmont Pl, Tigard, OR 97224 | 2016-08-23 |
| Find all providers in zip 97224 | ||||
| Taxonomy Code | 225700000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Massage Therapist |
| 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. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891301024 | Jenna Lari Johnston | Massage Therapist | 12662 Sw 127th Ave, Tigard, OR 97223-1859 | 2020-09-22 |
| 1073160172 | Mele Kali Smith | Massage Therapist | 12305 Sw Bell Ct, Tigard, OR 97223-1820 | 2019-08-22 |
| 1629536123 | Molly Ann Carlson | Massage Therapist | 7185 Sw Sandburg St Ste 100, Tigard, OR 97223-8090 | 2019-03-04 |
| 1477053429 | Marissa Emery | Massage Therapist | 7455 Sw Bridgeport Rd Ste E240, Tigard, OR 97224-7252 | 2018-02-16 |
| 1891211389 | Ashley A Doke | Massage Therapist | 7150 Sw Hampton St Ste 115, Tigard, OR 97223-8365 | 2017-08-17 |
| 1295251080 | Alexandra Rose Devivo | Massage Therapist | 12700 Sw North Dakota St Ste 180, Tigard, OR 97223-0802 | 2017-08-14 |
| 1023560729 | Samantha Suter | Massage Therapist | 11785 Sw Koski Dr, Tigard, OR 97223-5310 | 2016-10-28 |
| 1033664529 | Joanna Hutchins | Massage Therapist | 12353 Sw Walnut St, Tigard, OR 97223-3039 | 2016-08-24 |
| 1184070443 | Grounded Flow | Massage Therapist | 12085 Sw Hall Blvd, Tigard, OR 97223-6253 | 2016-05-05 |
| 1649632431 | Harriet Frances Carpenter | Massage Therapist | 9430 Sw Coral St. Suite 203, Tigard, OR 97223 | 2016-03-22 |
| Find all providers in TIGARD | ||||
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| 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.