Active NPI
Cristina Leigh Mandera, LMT
- Specialist
- Forest Grove, OR
National Provider Identifier
1861626152
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 15573
- Practice address
- 1911 Mountain View LN
Suite 200
Forest Grove, OR 97116-2382 - Phone
- (503) 357-2826
- NPI assigned
- May 14, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 15573 | OR | Primary |
Addresses
Primary practice location
1911 Mountain View LN
Suite 200
Forest Grove, OR 97116-2382
Mailing address
7450 S. Eastern Ave
Unit #1084
Las Vegas, NV 89123
Phone (702) 506-4595
Other names 1
- Mrs. Cristina Leigh Hubbard
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15573 | OR | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1242259200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1548720000000",
"number": "1861626152",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7450 S. EASTERN AVE",
"address_2": "UNIT #1084",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "89123",
"telephone_number": "702-506-4595"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1911 MOUNTAIN VIEW LN",
"address_2": "SUITE 200",
"city": "FOREST GROVE",
"state": "OR",
"postal_code": "971162382",
"telephone_number": "503-357-2826"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANDERA",
"first_name": "CRISTINA",
"middle_name": "LEIGH",
"credential": "LMT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-05-14",
"last_updated": "2019-01-29",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "OR",
"license": "15573",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "CRISTINA",
"last_name": "HUBBARD",
"middle_name": "LEIGH",
"prefix": "MRS.",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Forest Grove, OR
- Shannon Cathleen Lutz, O.D.
- Aidan J Lynch
- Christine June Ma
- Mandy Mie Yu Mah
- Managed Health Care of Oregon I LLC (Managed Healthcare of Or LLC)
- Maple Street Clinic Pharmacy LLC (Maple Street Clinic Pharmacy)
- Maple Street Clinic, PC
- Noah Marek, PT
- Marilyn J Booth MD
- Marquis Companies II, Inc (Marquis Forest Grove Assisted Living)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 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.