Individual provider · Type 1 NPI

Jebediah I. Sides, LMT

Massage Therapist · Vancouver, WA

NPI number 1619738804 Active

Practice location

14010 NE 3rd Ct Bldg B
Vancouver, WA 98685-2928

Call (360) 949-0133 Map

Fax (360) 768-5110

Mailing address

4414 NE 115th St
Vancouver, WA 98686-4479

Other practice locations

  • 11500 NE 119th St Ste 104, Vancouver, WA 98662-1643 · (360) 326-3396

Specialties and licenses

TaxonomyCodeLicense
Massage Therapist Primary 225700000X61512969 (WA)

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 1619738804

Jebediah I. Sides, LMT's National Provider Identifier is 1619738804, issued on Jan 16, 2024. The primary taxonomy on file is Massage Therapist (225700000X), and the practice location is in Vancouver, WA. The record was last updated on Dec 18, 2024.