Provider Demographics
NPI:1306230560
Name:ZUZIN, VICTOR (LMT)
Entity Type:Individual
Prefix:
First Name:VICTOR
Middle Name:
Last Name:ZUZIN
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:233 SE WASHINGTON ST
Mailing Address - Street 2:SUITE 103
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97123-4023
Mailing Address - Country:US
Mailing Address - Phone:503-352-9685
Mailing Address - Fax:
Practice Address - Street 1:233 SE WASHINGTON ST
Practice Address - Street 2:SUITE 103
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97123-4023
Practice Address - Country:US
Practice Address - Phone:503-352-9685
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-26
Last Update Date:2015-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR7416225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR7416OtherMASSAGE LICENSE