Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Max Mikelson

Individual provider Massage Therapist · NPI 1104787746

Max Mikelson is a Massage Therapist in Portland, Oregon. Practices as a sole proprietor. Licensed in Oregon.

Licensed in
OR
In the registry since
2025

Practice location Address checks out

3807 NE Killingsworth St
Portland, OR 97211-8021
Phone: (971) 420-5105
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Massage Therapist (primary) Taxonomy 225700000X · Licence 29343 (OR)

Record details

NPI number1104787746
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedNovember 22, 2025
Last updated in NPPESNovember 22, 2025
Certification dateNovember 22, 2025

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