Individual provider · Type 1 NPI

Nathan Isaiah Peterson, L.M.T.

Massage Therapist · Portland, OR

NPI number 1225489594 Active

Practice location

2390 NW Thurman St
Portland, OR 97210-2521

Call (541) 543-3512 Map

Mailing address

6530 SE 63rd Ave
Portland, OR 97206-7402

Specialties and licenses

TaxonomyCodeLicense
Massage Therapist Primary 225700000X21438 (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 1225489594

Nathan Isaiah Peterson, L.M.T.'s National Provider Identifier is 1225489594, issued on Jun 28, 2016. The primary taxonomy on file is Massage Therapist (225700000X), and the practice location is in Portland, OR. The record was last updated on Jun 28, 2016.