Provider Demographics
NPI:1891205068
Name:PERKINS, CHRISTINA LYNNE (LMT)
Entity Type:Individual
Prefix:MISS
First Name:CHRISTINA
Middle Name:LYNNE
Last Name:PERKINS
Suffix:
Gender:F
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:PO BOX 495
Mailing Address - Street 2:
Mailing Address - City:WILLAMINA
Mailing Address - State:OR
Mailing Address - Zip Code:97396-0495
Mailing Address - Country:US
Mailing Address - Phone:503-876-4485
Mailing Address - Fax:
Practice Address - Street 1:700 NE E ST
Practice Address - Street 2:
Practice Address - City:WILLAMINA
Practice Address - State:OR
Practice Address - Zip Code:97396-2721
Practice Address - Country:US
Practice Address - Phone:503-876-4485
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-02
Last Update Date:2017-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR4689225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty