Organization
NICHOLAS WILSON
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICHOLAS WILSON (LMT)
(503) 764-7595
Entity
Organization
Contact information
Practice address
10445 SW CANYON RD STE 103, BEAVERTON, OR 97005-1913
(503) 764-7595
Mailing address
10445 SW CANYON RD STE 103, BEAVERTON, OR 97005-1913
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
—
Other
Enumeration date
07/07/2025
Last updated
07/07/2025
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