Individual
NICHOLAS PETERKA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
1400 NW MARSHALL ST UNIT 108, PORTLAND, OR 97209-3367
(503) 208-6297
Mailing address
1400 NW MARSHALL ST UNIT 108, PORTLAND, OR 97209-3367
(503) 351-5144
(503) 351-5144
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
17741
OR
Other
Enumeration date
01/08/2020
Last updated
01/08/2020
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