Individual
NICHOLAS MICHAEL FAIRALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
9375 SW COMMERCE CIR STE A1, WILSONVILLE, OR 97070-9630
(503) 582-9200
Mailing address
4820 SW TUCKER AVE APT 425, BEAVERTON, OR 97005-2888
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
29286
OR
Other
Enumeration date
09/30/2025
Last updated
09/30/2025
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