MISTY L MORTENSEN (NPI# 1104312974) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104312974 |
| Entity Type | Individual |
| Full Name | MISTY L MORTENSEN |
| Practice Address |
551 Lone Pine Blvd The Dalles OR 97058-9403 |
| Mailing Address |
693 Dry Creek Rd Mosier OR 97040-9772 |
| Practice Telephone | 5415065779 |
| Mailing Telephone | 5302600995 |
| Enumeration Date | 2018-07-05 |
| Last Update Date | 2018-11-13 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225700000X | Massage Therapist | COS-FT-10118887 | OR | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
551 LONE PINE BLVD |
| City | THE DALLES |
| State | OR |
| Zip Code | 97058-9403 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538156005 | Alan N Peiris | Internal Medicine | 551 Lone Pine Blvd, The Dalles, OR 97058-9403 | 2005-09-30 |
| 1265057772 | Jennifer Zimmerman | Dietitian, Registered | 551 Lone Pine Blvd, The Dalles, OR 97058-9403 | 2020-06-10 |
| 1538706031 | Hopeanne Norris | Massage Therapist | 551 Lone Pine Blvd, The Dalles, OR 97058-9403 | 2019-12-03 |
| 1841767217 | Catherine M Brown | Massage Therapist | 551 Lone Pine Blvd, The Dalles, OR 97058-9403 | 2018-10-24 |
| 1063992790 | Brooke Kaylynn Small | Massage Therapist | 551 Lone Pine Blvd, The Dalles, OR 97058-9403 | 2018-08-21 |
| 1437674330 | Molly Elizabeth Mckee-nickson | Massage Therapist | 551 Lone Pine Blvd, The Dalles, OR 97058-9403 | 2017-08-11 |
| 1144745860 | Carmen Leigh Vance | Family Medicine | 551 Lone Pine Blvd, The Dalles, OR 97058-9403 | 2017-08-03 |
| 1548708795 | Arturo Carrillo Jr. | Physical Therapist | 551 Lone Pine Blvd, The Dalles, OR 97058-9403 | 2017-02-08 |
| 1447797576 | Linda Trefren | Massage Therapist | 551 Lone Pine Blvd, The Dalles, OR 97058-9403 | 2017-01-26 |
| 1801338066 | Courtney Phillips | Specialist/Technologist | 551 Lone Pine Blvd, Suite 302, The Dalles, OR 97058-9403 | 2016-11-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538646864 | Ashlee Kai Mcnamara | Behavior Technician | 2525 W 8th St., #34, The Dalles, OR 97058 | 2018-07-19 |
| 1548784689 | Mireya Moreno Ibarra | Behavior Technician | 401 East 3rd Street, Suite 101, The Dalles, OR 97058 | 2017-07-31 |
| 1407304991 | Joshua Seidel | Pharmacist | 515 Mt Hood St, The Dalles, OR 97058 | 2016-09-14 |
| 1366809048 | Mid-columbia Medical Center | Surgery | 1810 E. 19th St. #225, The Dalles, OR 97058 | 2016-01-26 |
| 1558731141 | Louise Goodnight | Case Manager/Care Coordinator | 419 East 7 Th Street, The Dalles, OR 97058 | 2015-09-25 |
| 1578944666 | Jessica Donnell | Dental Hygienist | 2529 E 12th St, The Dalles, OR 97058 | 2015-06-15 |
| 1487034328 | Savanna Schaan | Specialist | 609 W 14th St, The Dalles, OR 97058 | 2015-06-05 |
| 1801299102 | Mary E Zenorini | Social Worker | 1620 E. 12th St, The Dalles, OR 97058 | 2014-09-30 |
| 1669889143 | Diane Joan Irwin | Social Worker | 419 E 7th St #207, The Dalles, OR 97058 | 2014-07-17 |
| 1124452008 | Lacey A Nichols | Counselor | 312 E. Third St., The Dalles, OR 97058 | 2013-08-27 |
| Find all providers in zip 97058 | ||||
| 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 |
|---|---|---|---|---|
| 1942760426 | Emma Elizabeth Wiley | Massage Therapist | 508 Washington St Ste 13, The Dalles, OR 97058-2232 | 2019-03-21 |
| 1679810436 | Stephanie A Drew | Massage Therapist | 507 W 3rd Pl, The Dalles, OR 97058-1307 | 2013-01-13 |
| 1982907671 | Karen Lee Kaatz | Massage Therapist | 2724 E 12th St, The Dalles, OR 97058-4011 | 2010-12-18 |
| 1629211073 | Relissa Linn Wortman | Massage Therapist | 502 Washington St Ste 210, The Dalles, OR 97058-2270 | 2009-04-15 |
| 1699380741 | Jaune M Walton | Massage Therapist | 502 Washington St Ste 210, The Dalles, OR 97058-2270 | 2020-09-14 |
| 1538706031 | Hopeanne Norris | Massage Therapist | 551 Lone Pine Blvd, The Dalles, OR 97058-9403 | 2019-12-03 |
| 1841767217 | Catherine M Brown | Massage Therapist | 551 Lone Pine Blvd, The Dalles, OR 97058-9403 | 2018-10-24 |
| 1063992790 | Brooke Kaylynn Small | Massage Therapist | 551 Lone Pine Blvd, The Dalles, OR 97058-9403 | 2018-08-21 |
| 1437674330 | Molly Elizabeth Mckee-nickson | Massage Therapist | 551 Lone Pine Blvd, The Dalles, OR 97058-9403 | 2017-08-11 |
| 1447797576 | Linda Trefren | Massage Therapist | 551 Lone Pine Blvd, The Dalles, OR 97058-9403 | 2017-01-26 |
| Find all providers in THE DALLES | ||||
| City | THE DALLES |
| Zip Code | 97058 |
Please comment or provide details below to improve the information on MISTY L MORTENSEN.
| 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.