Provider Demographics
NPI:1306739263
Name:JOYNER, CORY S (LMT)
Entity type:Individual
Prefix:
First Name:CORY
Middle Name:S
Last Name:JOYNER
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:CORY
Other - Middle Name:
Other - Last Name:SHOEMAKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4878 SE POLLARD PL
Mailing Address - Street 2:
Mailing Address - City:MILWAUKIE
Mailing Address - State:OR
Mailing Address - Zip Code:97222-3253
Mailing Address - Country:US
Mailing Address - Phone:503-793-8676
Mailing Address - Fax:
Practice Address - Street 1:480 5TH ST
Practice Address - Street 2:
Practice Address - City:LAKE OSWEGO
Practice Address - State:OR
Practice Address - Zip Code:97034-3079
Practice Address - Country:US
Practice Address - Phone:503-793-8676
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-30
Last Update Date:2025-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR19372225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR19372OtherSTATE LICENSE