Individual
NICOLE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2253 NE CORNELL RD, HILLSBORO, OR 97124-5947
(971) 288-7435
Mailing address
3620 SW 70TH AVE, PORTLAND, OR 97225-2606
(503) 984-8854
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
28726
OR
Other
Enumeration date
07/23/2025
Last updated
07/23/2025
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