Healthcare Provider Details

I. General information

NPI: 1306755442
Provider Name (Legal Business Name): JAMES CARSON
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/03/2026
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2167 NW 185TH AVE
HILLSBORO OR
97124-7074
US

IV. Provider business mailing address

5924 NE GARFIELD AVE
PORTLAND OR
97211-3106
US

V. Phone/Fax

Practice location:
  • Phone: 503-828-1311
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number29892
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: