Jacob Nickerson, LMT - Portland, OR

Jacob Nickerson, LMT

Massage Therapist in Portland, Oregon

NPI 1205390671

Jacob Nickerson is a Massage Therapist based in Portland, OR. Jacob Nickerson practices in Portland, OR and has the professional credentials of LMT. The NPI Number for Jacob Nickerson is 1205390671 and holds a License No. 24524 (Oregon).

The current practice location address for Jacob Nickerson is 4305 Se Ellis St, Portland, OR and can be reached out via phone at 360-672-1811.

Location: 4305 Se Ellis St, Portland, OR, 97206-5758

NPI Number

1205390671

Provider Name

Jacob Nickerson

Credential

LMT

Provider Entity Type

Individual

Gender

Male

Address

4305 Se Ellis St, Portland, OR, 97206-5758

Phone Number

360-672-1811

Fax Number

Provider Enumeration Date

01/29/2019

Last Update Date

03/10/2024

Address

4305 Se Ellis St

City

Portland

State

Oregon

Zip

97206-5758

Phone Number

360-672-1811

Fax Number

Address

4305 Se Ellis St

City

Portland

State

Oregon

Zip

97206-5758

Phone Number

360-672-1811

Fax Number

Type

Respiratory, Developmental, Rehabilitative and Restorative Service Providers

Classification

Massage Therapist

Speciality

Taxonomy

225700000X

License No.

24524 (Oregon)

Definition

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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