Individual provider · Type 1 NPI

Jason Ishmael Ezzy, LMT, AHS

Massage Therapist · Portland, ME

NPI number 1083376396 Active

Practice location

1717 Congress St Ste 3
Portland, ME 04102-1983

Call (207) 449-2847 Map

Mailing address

365 Main St Apt 102
Biddeford, ME 04005-6304

Specialties and licenses

TaxonomyCodeLicense
Massage Therapist Primary 225700000XMT4860 (ME)

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 1083376396

Jason Ishmael Ezzy, LMT, AHS's National Provider Identifier is 1083376396, issued on Oct 13, 2021. The primary taxonomy on file is Massage Therapist (225700000X), and the practice location is in Portland, ME. The record was last updated on Oct 13, 2021.