Individual provider · Type 1 NPI

Jackie Johnson

Massage Therapist · Portland, OR

NPI number 1861940108 Active

Practice location

12923 NW Cornell Rd Ste 201
Portland, OR 97229-5834

Call (503) 646-3393 Map

Fax (503) 672-7042

Specialties and licenses

TaxonomyCodeLicense
Massage Therapist Primary 225700000X22647 (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 1861940108

Jackie Johnson's National Provider Identifier is 1861940108, issued on Sep 15, 2016. The primary taxonomy on file is Massage Therapist (225700000X), and the practice location is in Portland, OR. The record was last updated on Sep 15, 2016.