Johnnie San Nicolas 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. Johnnie San Nicolas NPI is 1760079347. 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:
3241 NE BROADWAY ST
PORTLAND, OR
ZIP 97232-814
Phone: (503) 282-8582
The enumeration date for this NPI number is 12/29/2020 and was last updated on 12/29/2020.