Individual provider · Type 1 NPI

Nicholas Michael Fairall, LMT

Massage Therapist · Wilsonville, OR

NPI number 1053285304 Active

Practice location

9375 SW Commerce Cir Ste A1
Wilsonville, OR 97070-9630

Call (503) 582-9200 Map

Mailing address

4820 SW Tucker Ave Apt 425
Beaverton, OR 97005-2888

Specialties and licenses

TaxonomyCodeLicense
Massage Therapist Primary 225700000X29286 (OR)

Massage Therapist: 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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About NPI 1053285304

Nicholas Michael Fairall, LMT's National Provider Identifier is 1053285304, issued on Sep 30, 2025. The primary taxonomy on file is Massage Therapist (225700000X), and the practice location is in Wilsonville, OR. The record was last updated on Sep 30, 2025.