IMIA ALEXANDRA HOLSTON (NPI# 1790334910) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790334910 |
| Entity Type | Individual |
| Full Name | IMIA ALEXANDRA HOLSTON |
| Credential | LMT |
| Practice Address |
4515 Sw Corbett Ave Portland OR 97239-4289 |
| Mailing Address |
4409 Ne Killingsworth St Unit 103 Portland OR 97218-1465 |
| Practice Telephone | 5032245464 |
| Mailing Telephone | 7735044804 |
| Enumeration Date | 2019-09-10 |
| Last Update Date | 2019-09-10 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225700000X | Massage Therapist | 25192 | OR | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
4515 SW CORBETT AVE |
| City | PORTLAND |
| State | OR |
| Zip Code | 97239-4289 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073684478 | Valerie A King | Chiropractor | 4515 Sw Corbett Ave, Portland, OR 97239-4289 | 2006-11-10 |
| 1508491200 | Elevate Wellness Chiropractic LLC | Massage Therapist | 4515 Sw Corbett Ave, Portland, OR 97239-4289 | 2020-03-03 |
| 1972162568 | Heather Marie Nagy | Massage Therapist | 4515 Sw Corbett Ave, Portland, OR 97239-4289 | 2019-06-07 |
| 1972006062 | Kelly Ann Murphy | Massage Therapist | 4515 Sw Corbett Ave, Portland, OR 97239-4289 | 2018-03-14 |
| 1306346267 | Melissa Abraham | Massage Therapist | 4515 Sw Corbett Ave, Portland, OR 97239-4289 | 2018-02-17 |
| 1104353655 | Luke Cameron Coleman | Massage Therapist | 4515 Sw Corbett Ave, Portland, OR 97239-4289 | 2017-05-15 |
| 1225429079 | Josh Adams | Massage Therapist | 4515 Sw Corbett Ave, Portland, OR 97239-4289 | 2015-02-16 |
| 1134488901 | King Chiropractic Clinic | Chiropractor | 4515 Sw Corbett Ave, Portland, OR 97239-4289 | 2012-05-14 |
| 1578882296 | Hayley Elana Gardner | Acupuncturist | 4515 Sw Corbett Ave, Portland, OR 97239-4289 | 2010-05-19 |
| 1598096760 | Seth Peter Perrine | Chiropractor | 4515 Sw Corbett Ave, Portland, OR 97239-4289 | 2010-01-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558979468 | Elise Caitlin Esposito | Student in an Organized Health Care Education/Training Program | 3710 Sw U.S. Veterans Hospital Road, Dental Service P-3 Dent, Attn: Elise Esposito, Portland, OR 97239 | 2020-07-16 |
| 1750908844 | Will Cowan | Student in an Organized Health Care Education/Training Program | 455 Sw Us Veterans Hospital Road., Portland, OR 97239 | 2020-07-06 |
| 1881219657 | Desiree Baer | Licensed Vocational Nurse | Sw Us Veterans Hospital Rd, Portland, OR 97239 | 2020-06-08 |
| 1285266205 | Melissa Irene Wheeler | Registered Nurse | Uhs-8l, 3181 S.w. Sam Jackson Park Road, Portland, OR 97239 | 2020-02-07 |
| 1225687981 | Pheba Mariam Jones | Pharmacist | Ohsu Pharmacy At Chh Building 2, 3303 Sw Bond Ave Rm 1090, Portland, OR 97239 | 2019-09-05 |
| 1801448063 | Alice Huang Huang | Student in an Organized Health Care Education/Training Program | 3710 Sw Veterans Road, Portland, OR 97239 | 2019-07-09 |
| 1710446273 | Ellen Noreen Kessi | Social Worker | 3710 Sw Us Veterans Rd., Portland, OR 97239 | 2019-03-14 |
| 1508335704 | Jacqueline Marie Mular | Marriage & Family Therapist | 5550 Sw Macadam Suite 100, Portland, OR 97239 | 2018-11-16 |
| 1275030926 | Carly Elizabeth Dougher | Student in an Organized Health Care Education/Training Program | Ohsu, 3181 Sw Sam Jackson Park Rd., Portland, OR 97239 | 2018-04-10 |
| 1780188094 | Dennis John Samuel | Student in an Organized Health Care Education/Training Program | Ohsu, 3181 Sw Sam Jackson Park Rd. L-579, Portland, OR 97239 | 2018-03-21 |
| Find all providers in zip 97239 | ||||
| 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 |
|---|---|---|---|---|
| 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 |
| 1205435716 | Michella Onnis | Massage Therapist | 2410 Se 10th Ave, Portland, OR 97214-4624 | 2020-10-26 |
| 1063019479 | Kevin Thomas Ryan | Massage Therapist | 2220 Nw Front Ave Apt 316, Portland, OR 97209-1998 | 2020-10-08 |
| 1497352389 | Nikki Nesta | Massage Therapist | 7849 Se Monroe St, Portland, OR 97222-1158 | 2020-10-05 |
| 1518574953 | Jessica Rose Hobbs | Massage Therapist | 1515 Sw Jefferson St Apt 15, Portland, OR 97201-6064 | 2020-09-29 |
| 1295340057 | Shane Dylan Adair | Massage Therapist | 2934 Se Stephens St, Portland, OR 97214-4960 | 2020-09-09 |
| 1518579416 | Scott Schwartz | Massage Therapist | 4425 S Corbett Ave, Portland, OR 97239-4260 | 2020-08-20 |
| 1134747074 | Katrina Hubbard | Massage Therapist | 1515 Sw 5th Ave, Portland, OR 97201-5406 | 2020-07-07 |
| 1407474539 | Kirstin Hoops | Massage Therapist | 1531 N Webster St, Portland, OR 97217-3752 | 2020-07-06 |
| Find all providers in PORTLAND | ||||
Please comment or provide details below to improve the information on IMIA ALEXANDRA HOLSTON.
| 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.