Search › Oregon › 225700000X
Jacob Nickerson, LMT
NPI 1205390671 · on the registry since 2019 · sole proprietor
Practice
- Address
- 4305 Se Ellis St
Portland, OR 97206 - Phone
- (360) 672-1811
Registry record
- Primary taxonomy
- 225700000X
225700000X
- Licence states on file
- OR
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2019-01-29
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Oregon