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

Mitchell T Fosnaugh

Individual provider Massage Therapist · NPI 1063360733

Mitchell T Fosnaugh is a Massage Therapist in Portland, Oregon. Practices as a sole proprietor. Licensed in Oregon.

Licensed in
OR
In the registry since
2026

Practice location Address checks out

844 N Emerson St
Portland, OR 97217-2533
Phone: (206) 503-1536
Show map & directions

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

Specialties & licences

Massage Therapist (primary) Taxonomy 225700000X · Licence 29526 (OR)

Record details

NPI number1063360733
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedMarch 18, 2026
Last updated in NPPESMarch 18, 2026
Certification dateMarch 18, 2026

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