Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Stanislav Kukushkin

Individual provider Massage Therapist · NPI 1275082067

Stanislav Kukushkin is a Massage Therapist in Portland, Oregon. Practices as a sole proprietor. Licensed in Oregon.

Licensed in
OR
In the registry since
2016

Practice location Address checks out

17221 SE Division St
Portland, OR 97236 Not confirmed with CMS for 10 years — call before visiting
Phone: (503) 760-0778
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Massage Therapist (primary) Taxonomy 225700000X · Licence 21741 (OR)

Record details

NPI number1275082067
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedSeptember 22, 2016
Last updated in NPPESSeptember 22, 2016

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