ANITA LYN PETERSON (NPI# 1558983569) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558983569 |
| Entity Type | Individual |
| Full Name | ANITA LYN PETERSON |
| Credential | LMT |
| Practice Address |
6645 Gleneden Beach Loop Gleneden Beach OR 97388-9700 |
| Mailing Address |
Po Box 94 Depoe Bay OR 97341-0094 |
| Practice Telephone | 5417643797 |
| Mailing Telephone | 5419618657 |
| Enumeration Date | 2020-05-13 |
| Last Update Date | 2020-05-13 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225700000X | Massage Therapist | 16662 | OR | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 23 Ne Williams Ave, Depoe Bay, OR 973411979 | 5419618657 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427124213 | Anita Peterson | Registered Nurse | 975 E. Third St, Chattanooga, TN 37403-2147 | 2006-11-26 |
| Street Address |
6645 GLENEDEN BEACH LOOP |
| City | GLENEDEN BEACH |
| State | OR |
| Zip Code | 97388-9700 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043218373 | Nicklis C Simpson | Dentist | 6645 Gleneden Beach Loop, Gleneden Beach, OR 97388-9700 | 2005-07-11 |
| 1528413291 | Beachside Family Dentistry | Dentist | 6645 Gleneden Beach Loop, Gleneden Beach, OR 97388-9700 | 2016-04-29 |
| 1275701880 | Marcie Howard | Massage Therapist | 6645 Gleneden Beach Loop, Gleneden Beach, OR 97388-9700 | 2008-02-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902068901 | Nancy Leah Resnikoff | Marriage & Family Therapist | 7760 Highway 101 N, Gleneden Beach, OR 97388 | 2008-06-30 |
| 1487832150 | Fran Diane Ferder | Psychologist | 7755 Hwy 101 Suite A2a, Gleneden Beach, OR 97388 | 2008-02-05 |
| 1528268034 | Dean Robins Wentworth | Nurse Practitioner | 6645 Gleneden Beach Loop Ste 1152, Gleneden Beach, OR 97388 | 2007-07-23 |
| 1235473554 | Renew Consulting, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 95 Laurel St, Gleneden Beach, OR 97388 | 2012-11-27 |
| 1508873779 | Vinod K Vinjamuri Md LLC | Internal Medicine | 6615 Gleneden Beach Loop, Gleneden Beach, OR 97388 | 2006-08-01 |
| 1841213246 | Nazmul Hoque Md LLC | Internal Medicine | 6615 Gleneden Beach Loop, Gleneden Beach, OR 97388 | 2006-07-26 |
| 1366659526 | Kathleen Diane Rich | Psychologist | 7755 Hwy 101, Market Place At Salishan Suite 1a1, Gleneden Beach, OR 97388-0244 | 2007-05-17 |
| 1720089345 | Vinod K Vinjamuri | Internal Medicine | 6615 Gleneden Beach Loop, Gleneden Beach, OR 97388-9700 | 2005-08-04 |
| 1427693340 | Sara Vanwinkle | Doula | 6905 Gleneden Beach Loop, 30b, Gleneden Beach, OR 97388-9738 | 2019-11-14 |
| 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 |
|---|---|---|---|---|
| 1275701880 | Marcie Howard | Massage Therapist | 6645 Gleneden Beach Loop, Gleneden Beach, OR 97388-9700 | 2008-02-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063013712 | Gabriel Henriques | Massage Therapist | 805 Se Peacock Ln, Portland, OR 97214-3278 | 2020-11-07 |
| 1871193490 | Heather R Anderson | Massage Therapist | 1646 Se Tenino St, Portland, OR 97202-6713 | 2020-11-01 |
| 1770183048 | Anna Schenk | Massage Therapist | 497 Sw Century Dr Ste 105, Bend, OR 97702-1167 | 2020-10-27 |
| 1205435716 | Michella Onnis | Massage Therapist | 2410 Se 10th Ave, Portland, OR 97214-4624 | 2020-10-26 |
| 1194324269 | Puanani Reid | Massage Therapist | 280 E Hersey St Ste B17, Ashland, OR 97520-1293 | 2020-10-20 |
| 1720686488 | Olivia Berryessa | Massage Therapist | 709 N Phoenix Rd, Medford, OR 97504-9488 | 2020-10-15 |
| 1548868466 | Massage Central LLC | Massage Therapist | 119 S Calapooia St, Sutherlin, OR 97479-8545 | 2020-10-13 |
| 1396343182 | Loretta K Bliss | Massage Therapist | 1635 Chemawa Rd Ne, Keizer, OR 97303-3639 | 2020-10-13 |
| 1982202149 | Hannah J Hamel | Massage Therapist | 1816 Cal Young Rd Apt 102, Eugene, OR 97401-2019 | 2020-10-11 |
| 1003414269 | Carlee Nicole Demore | Massage Therapist | 56880 Venture Ln # 215s, Sunriver, OR 97707-2158 | 2020-10-10 |
| Find all providers with the same taxonomy | ||||
| City | GLENEDEN BEACH |
| Zip Code | 97388 |
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| 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.