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

Mr. Andrei Vladimirovich Mitsourov, LMP

Individual provider Massage Therapist · NPI 1205104775

Mr. Andrei Vladimirovich Mitsourov, LMP is a Massage Therapist in Milton Freewater, Oregon. Practices as a sole proprietor. Licensed in Washington.

Licensed in
WA
In the registry since
2011
What do these letters mean?
LMP — Licensed Massage Practitioner
A state-licensed massage practitioner.

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Practice location Address checks out

53387 W Crockett Rd
Milton Freewater, OR 97862-7941
Phone: (509) 540-1665
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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 MA 60230518 (WA)

Record details

NPI number1205104775
Entity typeIndividual (Type 1)
GenderMale
Credentials LMP
Sole proprietorYes
NPI enumeratedDecember 12, 2011
Last updated in NPPESDecember 12, 2011

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