Kristine Marie Petrosyan, LMT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

25518 Issued in OR

Practice address

11565 SW Durham Rd Ste 110
Tigard, OR 97224-3553

Phone

(503) 639-0778

Fax

(503) 639-0815

NPI assigned

Nov 19, 2019

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Cornerstone Chiropractic, LLC

  • Chiropractor
  • Tigard, OR
  • NPI 1881876704
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1574121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574121600000",
    "number": "1083250591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11565 SW DURHAM RD STE 110",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972243553",
            "telephone_number": "503-639-0778",
            "fax_number": "503-639-0815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11565 SW DURHAM RD STE 110",
            "city": "TIGARD",
            "state": "OR",
            "postal_code": "972243553",
            "telephone_number": "503-639-0778",
            "fax_number": "503-639-0815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETROSYAN",
        "first_name": "KRISTINE",
        "middle_name": "MARIE",
        "credential": "LMT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-19",
        "last_updated": "2019-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "OR",
            "license": "25518",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Catherine Ann Petersen, LMT
• Daniele Paige Peterson, B.S.
• Hannah Marie Peterson
• Matthew Peterson, D.C.
• Lynette Michelle Petibone
• Joshua Shane Pettigrew, D.C.
• Meagan Rene Pettigrove
• Karl Johan Pfalzgraff
• Mason Lorenzo Pfeifer
• Stephanie Pfeifer, RN

• Massage Therapist in Tigard, OR
• Providers in Tigard, OR by specialty
• Massage Therapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.