Individual provider · Type 1 NPI

Caleb Bruce Wilson, LMT

Massage Therapist · Portland, OR

NPI number 1093592875 Active

Practice location

2100 NE Broadway St Ste 125
Portland, OR 97232-1500

Call (503) 477-8222 Map

Mailing address

3615 SE Hawthorne Blvd Apt 7
Portland, OR 97214-5160

Specialties and licenses

TaxonomyCodeLicense
Massage Therapist Primary 225700000X26664 (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 1093592875

Caleb Bruce Wilson, LMT's National Provider Identifier is 1093592875, issued on Sep 13, 2023. The primary taxonomy on file is Massage Therapist (225700000X), and the practice location is in Portland, OR. The record was last updated on Sep 13, 2023.