Johnnie San Nicolas
Johnnie San Nicolas is a Massage Therapist in Portland, Oregon. Practices as a sole proprietor. Licensed in Oregon.
- Licensed in
- OR
- In the registry since
- 2020
Practice location Address checks out
3241 NE Broadway StPortland, OR 97232-1814
Phone: (503) 282-8582
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Massage Therapist (primary) | Taxonomy 225700000X · Licence 26117 (OR) |
|---|
Record details
| NPI number | 1760079347 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | Yes |
| NPI enumerated | December 29, 2020 |
| Last updated in NPPES | December 29, 2020 |
| Certification date | December 29, 2020 |
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