MEDICARE: MRS. SARA KITCHER LMT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225700000X	Massage Therapist	25506	OR

General Provider Information

NPI Number	:	1558034421
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SARA KITCHER LMT

Provider Business Mailing Address
First Line	:	3932 N BORTHWICK AVE
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97227-1224
Country	:	US
Telephone Number	:	971-917-9512
Fax Number	:

Provider Business Practice Location Address
First Line	:	2223 NE 47TH AVE
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97213-1911
Country	:	US
Telephone Number	:	971-917-9512
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/27/2021
Last Update Date	:	10/24/2024

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Directions to “ MRS. SARA KITCHER LMT” Practice Location

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