STANISLAV KUKUSHKIN
NPI 1275082067
Massage Therapist in Portland, OR

Q: What is the provider's specialty?

The provider's specialty is Massage Therapist with taxonomy code 225700000X.

Active since September 22, 2016

17221 SE DIVISION ST, PORTLAND, OR 97236(503) 760-0778 Get Directions Write a Review

NPPES record last updated: September 22, 2016. Verified against the NPPES registry weekly; last sync: July 19, 2026.

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About Stanislav Kukushkin NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

STANISLAV KUKUSHKIN (NPI 1275082067) is an individual massage therapist in Portland, Oregon, licensed in Oregon (21741) and active in the NPI registry since September 2016.

NPPES Registry Identity

NPI1275082067

Entity TypeIndividualMale

Primary Taxonomy225700000X

Provider Legal NameSTANISLAV KUKUSHKIN

Location Address17221 SE DIVISION STPortland, OR 97236

Mailing Address17221 Se Division StPortland, OR 97236 · (503) 760-0778

Phone(503) 760-0778

Sole ProprietorYes

Enumeration DateSeptember 22, 2016

✔ NPI 1275082067 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyMassage TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers

Taxonomy Code225700000X

License✔ Licensed in OR · 21741

Definition

An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes.

17221 SE DIVISION ST, Portland, OR 97236

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