Provider Demographics
NPI:1023452109
Name:NOCHISAKI, CHRISTINA LORRAINE (LMT)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:LORRAINE
Last Name:NOCHISAKI
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 1:2225 SE 38TH AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97214-5905
Mailing Address - Country:US
Mailing Address - Phone:503-381-4368
Mailing Address - Fax:
Practice Address - Street 1:2225 SE 38TH AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97214-5905
Practice Address - Country:US
Practice Address - Phone:503-381-4368
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-19
Last Update Date:2013-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR14261225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist