Individual provider · Type 1 NPI

Nathan David Banta, LMT

Massage Therapist · Clackamas, OR

NPI number 1174486120 Active

Practice location

9895 SE Sunnyside Rd Ste K
Clackamas, OR 97015-9745

Call (503) 653-0400 Map

Mailing address

2195 NW 18th Ave Apt 652
Portland, OR 97209-2478

Specialties and licenses

TaxonomyCodeLicense
Massage Therapist Primary 225700000X28831 (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 1174486120

Nathan David Banta, LMT's National Provider Identifier is 1174486120, issued on Dec 6, 2025. The primary taxonomy on file is Massage Therapist (225700000X), and the practice location is in Clackamas, OR. The record was last updated on Dec 6, 2025.