HOLLY PETERSEN (NPI# 1386021137) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386021137 |
| Entity Type | Individual |
| Full Name | HOLLY PETERSEN |
| Practice Address |
15081 Se 126th Ave Clackamas OR 97015-9257 |
| Practice Telephone | 5034198337 |
| Mailing Telephone | 5034198337 |
| Enumeration Date | 2015-04-30 |
| Last Update Date | 2015-05-01 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225700000X | Massage Therapist | 11496 | OR | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083184402 | Holly Marie Petersen | Community Health Worker | 1020 S Main St # 200, Salt Lake City, UT 84101-3176 | 2018-11-28 |
| 1760806103 | Holly Petersen | Marriage & Family Therapist | 1143 47th Ave, Long Island City, NY 11101-5465 | 2014-02-05 |
| 1114230547 | Holly Anne Petersen | Physical Therapist | 186 Summer St, Kingston, MA 02364-1282 | 2010-07-14 |
| Street Address |
15081 SE 126TH AVE |
| City | CLACKAMAS |
| State | OR |
| Zip Code | 97015-9257 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184103517 | Laurel Perilli | Physical Therapist | 12550 Se 93rd Ave Ste 265, Clackamas, OR 97015 | 2018-08-07 |
| 1306324538 | Kristin Connor Messing | Physical Therapist | 4805 Ne Glisan St, Prov Hall 7e06, Portland, OR 97015 | 2018-07-31 |
| 1902317266 | Darcy Jones Hamrick | Counselor | 12901 Se 97th Ave., Suite 340, Clackamas, OR 97015 | 2017-10-13 |
| 1841723384 | Manon Lavoie | Chiropractor | 17105 Se Sunnyside Rd, Suite 148, Happy Valley, OR 97015 | 2017-04-11 |
| 1235670126 | Michael G Short | Pedorthist | 10117 Se Sunnyside Rd., Ste. H, Clackamas, OR 97015 | 2017-03-13 |
| 1487100756 | Michael Joseph Peizner | Pharmacist | 16300se Evelyn Street, Clackamas, OR 97015 | 2016-08-28 |
| 1316395619 | Jennifer Elaine Walkowski | Physical Therapist | 9100 Se Sunnyside Road, Clackamas, OR 97015 | 2016-05-26 |
| 1649635384 | Brookside Dental - Milwaukie, LLC | Dentist | 9225 Se Sunnyside Rd. Ste 1, Clackamas, OR 97015 | 2015-12-23 |
| 1801216130 | Robert D. Grew Dmd, Inc. | Dentist | 10163 Se Sunnyside Road, Suite 414, Clackamas, OR 97015 | 2014-04-25 |
| 1508205410 | Valerie P Tabalno | Massage Therapist | 15661 Se 82nd Dr, Clackamas, OR 97015 | 2013-06-25 |
| Find all providers in zip 97015 | ||||
| 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 |
|---|---|---|---|---|
| 1184247041 | Urban Massage LLC | Massage Therapist | 13043 Se 84th Ave, Clackamas, OR 97015-9798 | 2020-05-26 |
| 1265065205 | April Lee | Massage Therapist | 12010 Se Sunnyside Rd, Clackamas, OR 97015-8381 | 2020-02-18 |
| 1447812706 | Amanda Marie Drakulich | Massage Therapist | 9126 Se Saint Helens St # 100a, Clackamas, OR 97015-9780 | 2019-07-07 |
| 1396213104 | Todd Garretson | Massage Therapist | 8800 Se Sunnyside Rd Ste 253s, Clackamas, OR 97015-5702 | 2018-11-09 |
| 1881185734 | Yuelian Gan White | Massage Therapist | 16054 Se 82nd Dr, Clackamas, OR 97015-9567 | 2018-05-27 |
| 1205291432 | Stephen Weis | Massage Therapist | 10117 Se Sunnyside Rd Ste F206, Clackamas, OR 97015-7708 | 2015-12-14 |
| 1679998330 | Imuya Lee Dooley Mcdaniel | Massage Therapist | 14010 Se 97th Ave, Clackamas, OR 97015-8660 | 2014-03-04 |
| 1508205410 | Valerie P Tabalno | Massage Therapist | 15661 Se 82nd Dr, Clackamas, OR 97015 | 2013-06-25 |
| 1831442136 | Jason M Hardy | Massage Therapist | 8880 Se Casablanca Ct., Clackamas, OR 97015 | 2012-10-24 |
| 1447549308 | Jade Nelson | Massage Therapist | 9895 Sw Sunnyside Rd, Clackamas, OR 97015 | 2011-03-31 |
| Find all providers in CLACKAMAS | ||||
Please comment or provide details below to improve the information on HOLLY PETERSEN.
| 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.