Stanislav Kukushkin - Portland, OR

Stanislav Kukushkin

Massage Therapist in Portland, Oregon

NPI 1275082067

Stanislav Kukushkin is a Massage Therapist based in Portland, OR. Stanislav Kukushkin practices in Portland, OR. The NPI Number for Stanislav Kukushkin is 1275082067 and holds a License No. 21741 (Oregon).

The current practice location address for Stanislav Kukushkin is 17221 Se Division St, Portland, OR and can be reached out via phone at 503-760-0778.

Location: 17221 Se Division St, Portland, OR, 97236

NPI Number

1275082067

Provider Name

Stanislav Kukushkin

Credential

Provider Entity Type

Individual

Gender

Male

Address

17221 Se Division St, Portland, OR, 97236

Phone Number

503-760-0778

Fax Number

Provider Enumeration Date

09/22/2016

Last Update Date

03/09/2024

Address

17221 Se Division St

City

Portland

State

Oregon

Zip

97236

Phone Number

503-760-0778

Fax Number

Address

17221 Se Division St

City

Portland

State

Oregon

Zip

97236

Phone Number

503-760-0778

Fax Number

Type

Respiratory, Developmental, Rehabilitative and Restorative Service Providers

Classification

Massage Therapist

Speciality

Taxonomy

225700000X

License No.

21741 (Oregon)

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.

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