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

Kenneth Daniel Fuller, LMT

Individual provider Massage Therapist · NPI 1326665670

Kenneth Daniel Fuller, LMT is a Massage Therapist in Portland, Oregon. Licensed in Oregon. Registered with an NPI since 2020.

Licensed in
OR
In the registry since
2020
What do these letters mean?
LMT — Licensed Massage Therapist
A state-licensed massage therapist.

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Practice location Address checks out

9112 N Polk Ave
Portland, OR 97203-2320
Phone: (503) 660-6154
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Massage Therapist (primary) Taxonomy 225700000X · Licence 12913 (OR)

Record details

NPI number1326665670
Entity typeIndividual (Type 1)
GenderMale
Credentials LMT
Sole proprietorNo
NPI enumeratedJuly 2, 2020
Last updated in NPPESJuly 2, 2020
Certification dateJuly 2, 2020

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