STANISLAV KUKUSHKIN (NPI# 1275082067) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275082067 |
| Entity Type | Individual |
| Full Name | STANISLAV KUKUSHKIN |
| Practice Address |
17221 Se Division St Portland OR 97236 |
| Practice Telephone | 5037600778 |
| Mailing Telephone | 5037600778 |
| Enumeration Date | 2016-09-22 |
| Last Update Date | 2016-09-22 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225700000X | Massage Therapist | 21741 | OR | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
17221 SE DIVISION ST |
| City | PORTLAND |
| State | OR |
| Zip Code | 97236 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437455060 | Linda D Brown | Massage Therapist | 17221 Se Division St, Portland, OR 97236-1240 | 2011-01-29 |
| 1306321906 | Diana Shapovalova | Massage Therapist | 17221 Se Division St, Portland, OR 97236-1240 | 2018-09-28 |
| 1962916742 | Mary Nicole Grizhuk | Massage Therapist | 17221 Se Division St, Portland, OR 97236-1240 | 2017-11-30 |
| 1801321971 | Jeffrey Alan Anderson | Chiropractor | 17221 Se Division St, Portland, OR 97236-1240 | 2017-04-26 |
| 1407248859 | Pacific Chiropractic & Wellness Center, LLC | Chiropractor | 17221 Se Division St, Ste 21, Portland, OR 97236-1240 | 2015-02-23 |
| 1801222682 | Alla A Lobasyuk | Chiropractor | 17221 Se Division St, Portland, OR 97236-1240 | 2013-09-24 |
| 1154757664 | Andre Raymond Laurier Jr. | Massage Therapist | 17221 Se Division St, Portland, OR 97236-1240 | 2013-09-17 |
| 1992049712 | Mary Vaandering | Specialist | 17221 Se Division St, S-21, Portland, OR 97236-1240 | 2012-11-16 |
| 1396002614 | Artur S Snegur | Specialist | 17221 Se Division St, Ste. 21, Portland, OR 97236-1240 | 2012-04-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336650357 | Wondmimu Edao Chako | Registered Nurse | 3708 Se 144th Avenue, Portland, OR 97236 | 2017-10-17 |
| 1881142388 | John Ho | Pharmacist | 14700 Se Division St., Portland, OR 97236 | 2016-09-14 |
| 1306392527 | Lori-ann Lima | Nurse Practitioner | Multnomah County Health Department- Mid Cty Health Ctr, 12710 Se Division St, Portland, OR 97236 | 2016-08-28 |
| 1982096202 | Allan Fitzpatrick Beals-gibson | Adult Companion | 15602 Se Division St., Portland, OR 97236 | 2015-02-24 |
| 1386047132 | Columbiacare Services | Community Based Residential Treatment Facility, Mental Illness | 3530 Se 136th Ave. #5, Portland, OR 97236 | 2014-10-07 |
| 1356750319 | Kendra Harding | Counselor | 17214 Se Division Street, Portland, OR 97236 | 2014-08-04 |
| 1659790400 | Nghia Tran | Pharmacist | 8438 Se 138th Dr, Portland, OR 97236 | 2014-04-09 |
| 1942623764 | Laurel Katherine Hallock Koppelman | Nurse Practitioner | 12720 Se Division Street, Portland, OR 97236 | 2014-01-30 |
| 1982046249 | Victoria D Lathrop | Massage Therapist | 17221 Se Divistion St S-21, Portland, OR 97236 | 2013-07-26 |
| 1669819694 | Ariann Von Vaughn | Dental Hygienist | 18011 Se Pershing Ct, Portland, OR 97236 | 2013-05-31 |
| Find all providers in zip 97236 | ||||
| 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 |
|---|---|---|---|---|
| 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 | ||||
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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.