Individual
PAKE R. NIELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
7318 N LEAVITT AVE, PORTLAND, OR 97203-4840
(503) 567-5880
(866) 629-1294
Mailing address
8532 N IVANHOE ST STE 201, PORTLAND, OR 97203-4827
(503) 567-5880
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
27782
OR
Other
Enumeration date
06/29/2023
Last updated
04/23/2025
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