Basic Information
| Provider Information | |||||||||
| NPI: | 1013293893 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CYPHERS | ||||||||
| FirstName: | ROBIN | ||||||||
| MiddleName: | ELIZABETH | ||||||||
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| Credential: | LMT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1200 OVERLOOK DR | ||||||||
| Address2: | |||||||||
| City: | LAKE OSWEGO | ||||||||
| State: | OR | ||||||||
| PostalCode: | 970346605 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5033482265 | ||||||||
| FaxNumber: | 5036364583 | ||||||||
| Practice Location | |||||||||
| Address1: | 1200 OVERLOOK DR | ||||||||
| Address2: | |||||||||
| City: | LAKE OSWEGO | ||||||||
| State: | OR | ||||||||
| PostalCode: | 970346605 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5033482265 | ||||||||
| FaxNumber: | 5036364583 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/25/2011 | ||||||||
| LastUpdateDate: | 05/24/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 05/24/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225700000X | 15234 | OR | N | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Massage Therapist | 171100000X | AC209789 | OR | Y | 193200000X MULTI-SPECIALTY GROUP | Other Service Providers | Acupuncturist |
No ID Information.