Individual
NICOLE ALEXIS WORTHINGTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
2262 N ALBINA AVE STE 131, PORTLAND, OR 97227-1793
(714) 615-5412
Mailing address
8408 N BRANDON AVE UNIT 305, PORTLAND, OR 97217-6884
(714) 615-5412
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
27419
OR
Other
Enumeration date
11/13/2023
Last updated
11/13/2023
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