Kenneth Daniel Fuller, LMT - Portland, OR

Kenneth Daniel Fuller, LMT

Massage Therapist in Portland, Oregon

NPI 1326665670

Kenneth Daniel Fuller is a Massage Therapist based in Portland, OR. Kenneth Daniel Fuller practices in Portland, OR and has the professional credentials of LMT. The NPI Number for Kenneth Daniel Fuller is 1326665670 and holds a License No. 12913 (Oregon).

The current practice location address for Kenneth Daniel Fuller is 9112 N Polk Ave, Portland, OR and can be reached out via phone at 503-660-6154.

Location: 9112 N Polk Ave, Portland, OR, 97203-2320

NPI Number

1326665670

Provider Name

Kenneth Daniel Fuller

Credential

LMT

Provider Entity Type

Individual

Gender

Male

Address

9112 N Polk Ave, Portland, OR, 97203-2320

Phone Number

503-660-6154

Fax Number

Provider Enumeration Date

07/02/2020

Last Update Date

03/10/2024

Address

9112 N Polk Ave

City

Portland

State

Oregon

Zip

97203-2320

Phone Number

503-660-6154

Fax Number

Address

9112 N Polk Ave

City

Portland

State

Oregon

Zip

97203-2320

Phone Number

503-660-6154

Fax Number

Type

Respiratory, Developmental, Rehabilitative and Restorative Service Providers

Classification

Massage Therapist

Speciality

Taxonomy

225700000X

License No.

12913 (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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