JACOB NICKERSON

PORTLAND, OR
NPI1205390671
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy225700000X Massage Therapist
(Licence: OR  24524)
Enumeration Date2019-01-29
Last Update Date2019-01-29
Business Address
JACOB NICKERSON LMT
4305 SE ELLIS ST
PORTLAND, OR 97206-5758
Phone number: 360-672-1811
Mailing Address
JACOB NICKERSON LMT
4305 SE ELLIS ST
PORTLAND, OR 97206-5758
Phone number: 360-672-1811