Provider Demographics
NPI:1386987485
Name:MUELLER, CHRISTINA M (LMT)
Entity type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:M
Last Name:MUELLER
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:CHRISTINA
Other - Middle Name:M
Other - Last Name:MITSCHE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:14200 SW KIMBERLY DR
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97008
Mailing Address - Country:US
Mailing Address - Phone:503-504-0161
Mailing Address - Fax:
Practice Address - Street 1:412 JEFFERSON PKWY STE 204
Practice Address - Street 2:
Practice Address - City:LAKE OSWEGO
Practice Address - State:OR
Practice Address - Zip Code:97035-1251
Practice Address - Country:US
Practice Address - Phone:971-245-6383
Practice Address - Fax:503-477-5865
Is Sole Proprietor?:No
Enumeration Date:2013-03-27
Last Update Date:2019-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR13018225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist