MRS. LOIS ELIZABETH YEVDALCIA DIMICK (NPI# 1629102454) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1629102454 |
Entity Type | Individual |
Full Name | MRS. LOIS ELIZABETH YEVDALCIA DIMICK |
Other Name | MISS LOIS ELIZABETH YEVDALCIA CAMARILLO |
Credential | LMT |
Practice Address |
2004 Main St Suite 204 Forest Grove OR 97116 |
Mailing Address |
1912 28th Ave Forest Grove OR 97116 |
Practice Telephone | 5033807753 |
Practice Fax Number | 5033594760 |
Mailing Telephone | 5033807753 |
Mailing Fax Number | 5033594760 |
Enumeration Date | 2007-03-15 |
Last Update Date | 2007-07-08 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 225700000X | Massage Therapist | 11715 | OR | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Street Address |
2004 MAIN ST SUITE 204 |
City | FOREST GROVE |
State | OR |
Zip Code | 97116 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1124286125 | Maudeen Grace Jordan | Social Worker | 2004 Main St, Suite 203, Forest Grove, OR 97116-2349 | 2008-05-27 |
1518088012 | Tonnie Irene White | Massage Therapist | 2004 Main St, Ste 202, Forest Grove, OR 97116 | 2007-04-02 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1780220988 | Jenny Park | Social Worker | 2023 Hawthorne Street, Building C, Forest Grove, OR 97116 | 2019-11-22 |
1447742077 | Kimberly K Sabin | Doula | 1239 Goff Rd, Forest Grove, OR 97116 | 2018-05-30 |
1891205266 | Sonam Narayan | Optometrist | 2221 Pacific Avenue, Forest Grove, OR 97116 | 2017-10-11 |
1013260181 | Sharon Louise Benjamin | Nurse Practitioner | 2724 Harvest Ct, Forest Grove, OR 97116 | 2012-10-25 |
1336445535 | Shane Michael Peterson | Physical Therapist | 3300 19th Avenue, Forest Grove, OR 97116 | 2011-02-04 |
1023324415 | Kara Marie Cooper | Registered Nurse | 2221 Oak St, Forest Grove, OR 97116 | 2010-08-24 |
1811229792 | Rachel Lucinda Erin Dilly | Speech-Language Pathologist | 3300 19th Ave., Forest Grove, OR 97116 | 2010-02-03 |
1720286339 | Thuymai Anna Fee | Physical Therapist | Custom Care Physical Therapy, 4150 Pacific Ave. #100, Forest Grove, OR 97116 | 2007-07-05 |
1023159936 | Ninette Kay Foster | Contractor | 2329 Pacific Ave., Forest Grove, OR 97116 | 2007-02-12 |
1063573970 | James D Surface | Physical Therapist | 1909 Mountain View Ln #300, Forest Grove, OR 97116 | 2006-12-13 |
Find all providers in zip 97116 |
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 |
---|---|---|---|---|
1306480249 | Maryanne Elizabeth Schiller | Massage Therapist | 2328 Pacific Ave Rm 500, Forest Grove, OR 97116-2450 | 2019-11-04 |
1619496429 | Kimber Le Hardin | Massage Therapist | 2004 Main St Ste 311, Forest Grove, OR 97116-7338 | 2017-09-12 |
1720481518 | Restore Massage Therapy, Inc | Massage Therapist | 1922 21st Ave, Forest Grove, OR 97116-1638 | 2014-10-07 |
1477891323 | Shannon Raphael Hallberg | Massage Therapist | 2318 Pacific Ave, Forest Grove, OR 97116-2450 | 2013-01-28 |
1295007466 | Alan Robert Liljenberg | Massage Therapist | 1911 Mountain View Ln Ste 400, Forest Grove, OR 97116-2248 | 2012-02-03 |
1356638712 | Jeremiah Joseph Klingler | Massage Therapist | 2735 20th Pl Ste A, Forest Grove, OR 97116-2890 | 2011-07-06 |
1063666451 | Theron A. Chandler | Massage Therapist | 1802 Tamarack Way, Forest Grove, OR 97116-2155 | 2008-11-11 |
1275674210 | Karen Anne Sotto | Massage Therapist | 2313 A St, Forest Grove, OR 97116-1405 | 2007-02-11 |
1053359521 | Melinda Grace Apodaca | Massage Therapist | 1922 21st Ave., Forest Grove, OR 97116 | 2006-06-04 |
1528665502 | Jaclyn Sorbets | Massage Therapist | 3838 Pacific Ave, Forest Grove, OR 97116-2224 | 2020-10-03 |
Find all providers in FOREST GROVE |
City | FOREST GROVE |
Zip Code | 97116 |
Please comment or provide details below to improve the information on MRS. LOIS ELIZABETH YEVDALCIA DIMICK.
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.