Individual provider · Type 1 NPI

Jaedon Churchill Dicks, LMT

Massage Therapist · Portland, OR

NPI number 1194510958 Active

Practice location

7318 N Leavitt Ave
Portland, OR 97203-4840

Call (503) 567-5880 Map

Mailing address

8222 N Edison St
Portland, OR 97203-4912

Specialties and licenses

TaxonomyCodeLicense
Massage Therapist Primary 225700000X28873 (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.

8 other providers at this address

Other massage therapist providers in Portland

See all in Portland →

About NPI 1194510958

Jaedon Churchill Dicks, LMT's National Provider Identifier is 1194510958, issued on Apr 11, 2025. The primary taxonomy on file is Massage Therapist (225700000X), and the practice location is in Portland, OR. The record was last updated on Apr 22, 2025.