Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. ANDREI VLADIMIROVICH MITSOUROV, LMP
Active Sole ProprietorMR. ANDREI VLADIMIROVICH MITSOUROV, LMP is a Massage Therapist healthcare provider located in MILTON FREEWATER, Oregon. NPI 1205104775 is currently active in the NPPES registry. Verify at CMS.
Massage Therapist · MILTON FREEWATER, OR
Registration Details
- NPI Number
- 1205104775
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Dec 12, 2011 (14.629913945483 yrs)
- Last Updated
- Dec 12, 2011
- License
-
MA 60230518 (WA)
- Sole Proprietor
- Yes
Practice Information
- Address
-
53387 W CROCKETT RDMILTON FREEWATER, OR, 978627941Browse OR providers · Browse ZIP 97862
- Phone
- 5095401665
- Primary Specialty
-
Massage Therapist
225700000X
Other Massage Therapist Providers in MILTON FREEWATER, OR
| Name | Credential | NPI |
|---|---|---|
| TAWNYA LYNN LAGE | LMP | 1376863399 |
| DANIELLE STRICKLAND | LMP | 1821475286 |
| PAKSUPIM COLE | L.M.T. | 1528538352 |
| MS. LACEY ELIZABETH ROSE KLEM | LMT | 1356812192 |
| HEIDI JO MAYBERRY | LMT | 1285389932 |
| KAYLEE BROWN | LMT | 1033845805 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.