MEDICARE: NICHOLAS WILSON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225700000X	Massage Therapist

General Provider Information

NPI Number	:	1215827886
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NICHOLAS WILSON

Provider Business Mailing Address
First Line	:	10445 SW CANYON RD STE 103
Second Line	:
City	:	BEAVERTON
State	:	OR
Zip	:	97005-1913
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	10445 SW CANYON RD STE 103
Second Line	:
City	:	BEAVERTON
State	:	OR
Zip	:	97005-1913
Country	:	US
Telephone Number	:	503-764-7595
Fax Number	:

Authorized Official
Title or Position	:	LMT
Name	:	NICHOLAS WILSON
Credential	:
Telephone Number	:	503-764-7595

Provider Enumeration Date	:	07/07/2025
Last Update Date	:	07/07/2025

Similar Medicare Providers

1568800068 — PATRICK GALLAHER RPH, MBA, MPH
Practice Location Address:

4855 SW WESTERN AVE.
BEAVERTON, OR
97005-1913

Practice Phone: 503-277-2818
Practice Fax:

1790506251 — IVYS MASSAGE AND BODYWORK
Practice Location Address:

10445 SW CANYON RD STE 103
BEAVERTON, OR
97005-1913

Practice Phone: 971-444-0326
Practice Fax: 971-600-9175

1730902941 — WYNN STREET LLC
Practice Location Address:

10445 SW CANYON RD STE 114
BEAVERTON, OR
97005-1913

Practice Phone: 971-303-9360
Practice Fax:

1669298584 — JODI WYNN TURNER
Practice Location Address:

10445 SW CANYON RD STE 114
BEAVERTON, OR
97005-1913

Practice Phone: 971-303-9360
Practice Fax:

1710937909 — PATRICIA HALLAM L.AC.
Practice Location Address:

5075 SW GRIFFITH DR STE 210
BEAVERTON, OR
97005-3045

Practice Phone: 503-421-9339
Practice Fax: 503-530-8174

1578704573 — A NEW VISION, P.C.
Practice Location Address:

4655 SW GRIFFITH DR , SUITE #165
BEAVERTON, OR
97005-8728

Practice Phone: 503-646-8592
Practice Fax: 503-526-3989

Directions to “NICHOLAS WILSON ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.