ETHAN W TREVINO (NPI# 1942894290) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942894290 |
| Entity Type | Individual |
| Full Name | ETHAN W TREVINO |
| Gender | Male |
| Credential | LMT |
| Practice Address | 5253 Ne Sandy Blvd Portland OR 97213-2562 |
| Practice Telephone | 5038935131 |
| Mailing Address | 64770 Big Buck Dr Deer Island OR 97054-9418 |
| Mailing Telephone | 8016863612 |
| Certification Date | 2021-02-26 |
| Enumeration Date | 2021-02-26 |
| Last Update Date | 2021-02-26 |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | Group | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|---|
| Y | 225700000X | Massage Therapist | 26242 | OR | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address | 5253 NE SANDY BLVD |
| City | PORTLAND |
| State | OR |
| Zip Code | 97213-2562 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457981045 | Taylor Walker | Massage Therapist | 5253 Ne Sandy Blvd, Portland, OR 97213-2562 | 2020-01-22 |
| 1861989386 | Catherine Soncrant | Massage Therapist | 5253 Ne Sandy Blvd, Portland, OR 97213-2562 | 2018-04-19 |
| 1487169371 | Nicole Kennedy · Nicole Pease | Chiropractor | 5253 Ne Sandy Blvd, Portland, OR 97213-2562 | 2017-12-13 |
| 1528436276 | Molly Mcmullen | Massage Therapist | 5253 Ne Sandy Blvd, Portland, OR 97213-2562 | 2015-09-11 |
| 1134566573 | Loretta Marie Grisaffi | Massage Therapist | 5253 Ne Sandy Blvd, Portland, OR 97213 | 2013-05-24 |
| 1326369398 | Cascade Spine & Injury Center, LLC | Clinic/Center | 5253 Ne Sandy Blvd, Portland, OR 97213-2562 | 2010-06-14 |
| 1043532963 | Jonathan William Mcclaren | Chiropractor | 5253 Ne Sandy Blvd, Portland, OR 97213-2562 | 2010-02-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780235945 | Ivan Mercado | Massage Therapist | 5235 Ne Sandy Blvd, Portland, OR 97213-2562 | 2019-09-27 |
| 1841531308 | Kelley Curtis | Specialist | 5223 Ne Sandy Blvd, Portland, OR 97213-2562 | 2013-03-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922696202 | Kelly Landreth | Community Health Worker | 4400 Ne Halsey St Bldg 2 Third Floor, Portland, OR 97213 | 2021-01-04 |
| 1831715176 | Darnell Jackie Strong | Social Worker | 435 Ne 78th Ave 'Strong Counseling Services', Portland, OR 97213 | 2020-06-23 |
| 1336775907 | Redpoint Physical Therapy and Performance LLC | Physical Therapist | 4200 Ne Flanders St Unit B, Portland, OR 97213 | 2020-03-16 |
| 1801431218 | Denise Dorgan-Miller | Occupational Therapy Assistant | Providence Elder Place, 4400 Ne Halsey Suite 200, Portland, OR 97213 | 2019-11-08 |
| 1619435617 | Aspiration of Character Counseling Services, LLC | Counselor · Addiction (Substance Use Disorder) | 4424 Ne Glisan St, The Li Wellness Building, Second Floor, Portland, OR 97213 | 2019-03-08 |
| 1053886580 | Sandy Dental Pdx | Dentist | 7836 Ne Sandy Blvd, Portland, OR 97213 | 2018-10-11 |
| 1598248072 | Katelyn Boel | Pharmacist | 4400 Ne Halsey St, Building 2, 4th Floor, Portland, OR 97213 | 2018-09-11 |
| 1568944908 | Shaunti Basil | Physical Therapist | 4805 Ne Glisan Street, Portland, OR 97213 | 2018-09-01 |
| 1588143432 | Jessica Doskow | Physical Therapist | 507 Ne 47th Ave, Portland, OR 97213 | 2018-08-11 |
| 1578049631 | Credena Health LLC | Pharmacy · Community/Retail Pharmacy | 4805 Ne Glisan St Ste 11n321, Portland, OR 97213 | 2018-07-12 |
| Find all providers in zip 97213 | ||||
| Taxonomy Code | 225700000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Massage Therapist |
| 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. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629663422 | Kelly Lynn Jordan | 2304 E Burnside St Ste 1, Portland, OR 97214-1677 | 2021-03-03 | |
| 1346835428 | Amanda Fisher | 2303 E Burnside St., Portland, OR 97214-1655 | 2021-03-01 | |
| 1386238137 | Body Ritual LLC | 2933 Ne Broadway St, Portland, OR 97232-1760 | 2021-02-23 | |
| 1376137299 | Christopher George Mcclorey | 5440 Sw Westgate Dr Ste 100, Portland, OR 97221-2437 | 2021-02-22 | |
| 1285228239 | Holly V Bonadurer | 4531 Se Belmont St Ste 312, Portland, OR 97215-1693 | 2021-02-21 | |
| 1548854516 | Anna Belle Vacheresse · Anna Drahos-Vacheresse | 913 Sw 16th Ave, Portland, OR 97205-1730 | 2021-02-21 | |
| 1770176257 | Sarah Solano | 3014 Ne Killingsworth St, Portland, OR 97211-6814 | 2021-02-16 | |
| 1972196657 | Ashley Marion Dudley | 4927 Ne 30th Ave, Portland, OR 97211-7007 | 2021-02-14 | |
| 1194318055 | Alexandra J Moreland | 936 Se Ankeny St, Portland, OR 97214-1300 | 2021-02-11 | |
| 1528659513 | Kelly Behm | 1617 Ne 17th Ave, Portland, OR 97232-3561 | 2021-02-01 | |
| Find all providers in PORTLAND | ||||
| City | PORTLAND |
| Zip Code | 97213 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780923482 | Alivio Health Centers-Lee Trevino | Exclusive Provider Organization | 1331 N Lee Trevino Dr Ste B, El Paso, TX 79936-6475 | 2013-01-31 |
| 1710577762 | Tyler Trevino · Delbert T Trevino | Counselor · Mental Health | 4615 Alameda Ave, El Paso, TX 79905-2702 | 2021-01-24 |
| 1689048357 | Eduardo Trevino · Eddy Trevino | Dietitian, Registered | 2529 S 1st St, Austin, TX 78704-5466 | 2015-11-18 |
| 1669784898 | Ruth Ann Trevino | Emergency Medicine | 620 John Paul Jones Cir, C/O Ruth Trevino Gme Office Bldg 3 3rd Floor, Portsmouth, VA 23708-2111 | 2010-07-02 |
| 1194061721 | Cindy Trevino Serna · Cindy Michele Trevino | Counselor · Mental Health | 613 Elizabeth St, Suite 805, Corpus Christi, TX 78404-2220 | 2012-12-31 |
| 1124540851 | Perla Trevino · Perla Trevino Castillo | Nurse Practitioner · Family | 7121 S Padre Island Dr Ste 300, Corpus Christi, TX 78412-4940 | 2017-07-14 |
| 1174662696 | Theresa Trevino Arthur · Theresa Denise Trevino | Physician Assistant · Medical | 1602 E Houston St, Suite C, Beeville, TX 78102-5326 | 2007-02-05 |
| 1528051489 | Esther Trevino · Esther Trevino-De La Chaumiere | Marriage & Family Therapist | 2020 Forest Ave, Suite 6, San Jose, CA 95128-4805 | 2005-08-25 |
| 1821546888 | Wes Bransford Dental PC · Lee Trevino Dental | Clinic/Center · Dental | 1624 N Lee Trevino Dr, Suite A, El Paso, TX 79936-5100 | 2016-09-19 |
| 1801056403 | Annelle Trevino Gonzales · Annelle Trevino | Occupational Therapy Assistant | 871 Old Alice Rd, Suite 600, Brownsville, TX 78520-8268 | 2008-06-17 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.