Jacob Nickerson, LMT is a massage therapist in Portland, OR. The provider is 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. Jacob Nickerson, LMT NPI is 1205390671. The provider is registered as an individual entity type.
The NPPES NPI record indicates the provider is a male.
The provider's business location address is:
4305 SE ELLIS ST
PORTLAND, OR
ZIP 97206-758
Phone: (360) 672-1811
The enumeration date for this NPI number is 1/29/2019 and was last updated on 1/29/2019.