1. Home
  2. Directory
  3. Oregon
  4. Portland
  5. Massage Therapist
  6. NPI Profile

MAX MIKELSON
NPI 1104787746
Massage Therapist in Portland, OR

Active since November 22, 2025
3807 NE KILLINGSWORTH ST, PORTLAND, OR 97211(971) 420-5105 Get Directions Write a Review

NPPES record last updated: November 22, 2025. Verified against the NPPES registry weekly; last sync: October 04, 2026.

About Max Mikelson NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MAX MIKELSON (NPI 1104787746) is an individual massage therapist in Portland, Oregon, licensed in Oregon (29343) and active in the NPI registry since November 2025.

NPPES Registry Identity

NPI1104787746
Entity TypeIndividualMale
Primary Taxonomy225700000X
Provider Legal NameMAX MIKELSON
Location Address3807 NE KILLINGSWORTH STPortland, OR 97211-8021
Mailing Address3807 Ne Killingsworth StPortland, OR 97211-8021 · (971) 420-5105
Phone(971) 420-5105
Sole ProprietorYes
Enumeration DateNovember 22, 2025
NPPES CertifiedNovember 22, 2025
✔ NPI 1104787746 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyMassage TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Taxonomy Code225700000X
License✔ Licensed in OR · 29343
Definition
An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes.
3807 NE KILLINGSWORTH ST, Portland, OR 97211
Open in Google Maps ↗

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Max Mikelson's NPI number?

The NPI number for Max Mikelson is 1104787746. It was assigned to this individual provider in the NPPES registry on November 22, 2025.

Where is Max Mikelson located?

Max Mikelson practices at 3807 NE Killingsworth St, Portland, OR 97211. The listed phone number is (971) 420-5105.

What is Max Mikelson's specialty?

The primary specialty registered for this NPI is Massage Therapist with taxonomy code 225700000X.

When was this NPI record last updated?

The NPPES record for Max Mikelson was last updated on November 22, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.