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).
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 |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 225700000X | Massage Therapist | 12913 | OR | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
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 |
Street Address |
9112 N POLK AVE |
City | PORTLAND |
State | OR |
Zip Code | 97203-2320 |
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 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.