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NPI 1093950057

IndividualActive

Jason Johnson, MASSAGE THERAPIST

NPI 1093950057 · Contractor · Portland, OR

Provider details

NPI number: 1093950057
Entity type: Individual
Primary specialty: ContractorOther Service Providers
Credential: MASSAGE THERAPIST
Sex: Male
Sole proprietor: Yes
License: 12553 (OR)

Practice location

11120 Ne Halsey St

Portland, OR 97220-2021

Phone: (503) 252-5097

More OR providers

Mailing address

15420 Sw Mica Ln

Beaverton, OR 97007-9307

Registry dates

Enumerated: 2008-12-04
Last updated: 2008-12-04

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.

Jason Johnson, MASSAGE THERAPIST — NPI 1093950057, Portland, OR | NPI Central