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JOHNNIE SAN NICOLAS
NPI 1760079347
Massage Therapist in Portland, OR

Active since December 29, 2020
3241 NE BROADWAY ST, PORTLAND, OR 97232(503) 282-8582 Get Directions Write a Review

NPPES record last updated: December 29, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Johnnie San Nicolas NPPES

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

JOHNNIE SAN NICOLAS (NPI 1760079347) is an individual massage therapist in Portland, Oregon, licensed in Oregon (26117) and active in the NPI registry since December 2020.

NPPES Registry Identity

NPI1760079347
Entity TypeIndividualMale
Primary Taxonomy225700000X
Provider Legal NameJOHNNIE SAN NICOLAS
Location Address3241 NE BROADWAY STPortland, OR 97232-1814
Mailing Address3241 Ne Broadway StPortland, OR 97232-1814 · (503) 282-8582
Phone(503) 282-8582
Sole ProprietorYes
Enumeration DateDecember 29, 2020
NPPES CertifiedDecember 29, 2020
✔ NPI 1760079347 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 · 26117
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.
3241 NE BROADWAY ST, Portland, OR 97232
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Other Providers at the Same Location NPPES 19

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MS. KATHLEEN MARY JUDGE LMT
Specialist
3241 NE BROADWAY ST
PORTLAND, OR 97232
Multnomah County (503) 282-8582
CENTER FOR CHIROPRACTIC & PAIN REHABILITATION, LLC
Clinic/Center
3241 NE BROADWAY ST
PORTLAND, OR 97232
Multnomah County (503) 282-8582
ALEXA ISABEL HANSHAW LMT
Massage Therapist
3241 NE BROADWAY ST
PORTLAND, OR 97232
Multnomah County (503) 282-8582
AMELIA SCHILDMEYER
Chiropractor
3241 NE BROADWAY ST
PORTLAND, OR 97232
Multnomah County (503) 282-8582
LAURIE N NIXON LMT
Massage Therapist
3241 NE BROADWAY ST
PORTLAND, OR 97232
Multnomah County (503) 282-8582
DEBI CHRISTINE SELF LMT
Massage Therapist
3241 NE BROADWAY ST
PORTLAND, OR 97232
Multnomah County (503) 282-8582
DR. KRISTEN DOMINIQUE CASTILLON DC
Chiropractor
3241 NE BROADWAY ST
PORTLAND, OR 97232
Multnomah County (503) 282-8582
MR. WILLIAM G. NEIGHBORS LMT
Reflexologist
3241 NE BROADWAY ST
PORTLAND, OR 97232
Multnomah County (503) 282-8582

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 Johnnie San Nicolas's NPI number?

The NPI number for Johnnie San Nicolas is 1760079347. It was assigned to this individual provider in the NPPES registry on December 29, 2020.

Where is Johnnie San Nicolas located?

Johnnie San Nicolas practices at 3241 NE Broadway St, Portland, OR 97232. The listed phone number is (503) 282-8582.

What is Johnnie San Nicolas'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 Johnnie San Nicolas was last updated on December 29, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years 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.