Individual provider · Type 1 NPI

Jayde Theobald, LMT

Massage Therapist · Portland, OR

NPI number 1982937140 Active

Practice location

4642 SE Madison St
Portland, OR 97215-2572

Call (503) 313-6626 Map

Specialties and licenses

TaxonomyCodeLicense
Massage Therapist Primary 225700000X16457 (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 1982937140

Jayde Theobald, LMT's National Provider Identifier is 1982937140, issued on Sep 4, 2009. The primary taxonomy on file is Massage Therapist (225700000X), and the practice location is in Portland, OR. The record was last updated on Oct 30, 2014.