Individual provider · Type 1 NPI

Nicholas Mark Maxwell, LMT

Massage Therapist · Portland, OR

NPI number 1477136455 Active

Practice location

5300 NE 73rd Ave
Portland, OR 97218-3717

Call (512) 293-7721 Map

Other practice locations

  • 1421 SE Ankeny St, Portland, OR 97214-1471 · (503) 284-6996

Specialties and licenses

TaxonomyCodeLicense
Massage Therapist Primary 225700000X26275 (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 1477136455

Nicholas Mark Maxwell, LMT's National Provider Identifier is 1477136455, issued on Apr 28, 2021. The primary taxonomy on file is Massage Therapist (225700000X), and the practice location is in Portland, OR. The record was last updated on Apr 28, 2021.