Individual provider · Type 1 NPI

Kimberly Ann Petesky, LMT

Massage Therapist · Salem, OR

NPI number 1104522937 Active

Practice location

4356 Commercial St SE
Salem, OR 97302-3914

Call (503) 689-1216 Map

Mailing address

5134 Linda Ct SE
Salem, OR 97306-1789

Specialties and licenses

TaxonomyCodeLicense
Massage Therapist Primary 225700000X27221 (OR)

Massage Therapist: An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes.

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About NPI 1104522937

Kimberly Ann Petesky, LMT's National Provider Identifier is 1104522937, issued on Feb 2, 2023. The primary taxonomy on file is Massage Therapist (225700000X), and the practice location is in Salem, OR. The record was last updated on Feb 2, 2023.