Provider Demographics
NPI:1932471794
Name:PYKTEL, CHRISTINA (LMT)
Entity Type:Individual
Prefix:MS
First Name:CHRISTINA
Middle Name:
Last Name:PYKTEL
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 1:6855 SW CAPITOL HWY
Mailing Address - Street 2:APT. A
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97219-1960
Mailing Address - Country:US
Mailing Address - Phone:503-200-8367
Mailing Address - Fax:
Practice Address - Street 1:6855 SW CAPITOL HWY
Practice Address - Street 2:APT. A
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97219-1960
Practice Address - Country:US
Practice Address - Phone:503-200-8367
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-08
Last Update Date:2012-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR16564225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist