Individual provider · Type 1 NPI

Jessica Lynn Wallace, LMT

Massage Therapist · Gresham, OR

NPI number 1851807366 Active

Practice location

1217 NE Burnside Rd Ste 701D
Gresham, OR 97030-5770

Call (503) 665-8959 Map

Specialties and licenses

TaxonomyCodeLicense
Massage Therapist Primary 225700000X23622 (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 1851807366

Jessica Lynn Wallace, LMT's National Provider Identifier is 1851807366, issued on Dec 19, 2017. The primary taxonomy on file is Massage Therapist (225700000X), and the practice location is in Gresham, OR. The record was last updated on Mar 24, 2025.