Individual provider · Type 1 NPI

Niema Wilson, LMT

Massage Therapist · Portland, OR

NPI number 1912401134 Active

Practice location

1216 NW 21st Ave
Portland, OR 97209-1609

Call (503) 662-2490 Map

Mailing address

4110 SE Hawthorne Blvd # 905
Portland, OR 97214-5246

Specialties and licenses

TaxonomyCodeLicense
Massage Therapist Primary 225700000X24018 (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 1912401134

Niema Wilson, LMT's National Provider Identifier is 1912401134, issued on Mar 21, 2018. The primary taxonomy on file is Massage Therapist (225700000X), and the practice location is in Portland, OR. The record was last updated on Mar 21, 2018.