Jacob Nickerson, LMT
NPI 1205390671 · Massage Therapist · Portland, OR
Jacob Nickerson, LMT is a Massage Therapist provider in Portland, OR (NPI 1205390671).
Provider details
- NPI number
- 1205390671
- Entity type
- Individual
- Primary specialty
- Massage TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Credential
- LMT
- Sex
- Male
- Sole proprietor
- Yes
- License
- 24524 (OR)
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
7 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2019-01-29
- Last updated
- 2019-01-29
Frequently asked questions
- What is Jacob Nickerson's NPI number?
- Jacob Nickerson's National Provider Identifier (NPI) is 1205390671, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Jacob Nickerson's specialty?
- Jacob Nickerson is listed in the NPPES registry with a primary specialty of Massage Therapist (Respiratory, Developmental, Rehabilitative and Restorative Service Providers).
- Where is Jacob Nickerson located?
- Jacob Nickerson's practice location on file with NPPES is 4305 Se Ellis St, Portland, OR 97206-5758.
- What is Jacob Nickerson's phone number?
- The practice phone number listed in the NPPES registry for Jacob Nickerson is (360) 672-1811.
- Is Jacob Nickerson's NPI active?
- Yes — Jacob Nickerson's NPI (1205390671) is active in the NPPES registry as of the last update on 2019-01-29.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.