MEDICARE: NATHANIEL LEMKE LMT

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	29134	OR

General Provider Information

NPI Number	:	1588522262
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NATHANIEL LEMKE LMT

Provider Business Mailing Address
First Line	:	16850 SE WALNUT HILL RD
Second Line	:
City	:	AMITY
State	:	OR
Zip	:	97101-2100
Country	:	US
Telephone Number	:	503-341-2334
Fax Number	:

Provider Business Practice Location Address
First Line	:	3990 CHERRY AVE NE STE 103
Second Line	:
City	:	KEIZER
State	:	OR
Zip	:	97303-4888
Country	:	US
Telephone Number	:	971-332-5916
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/12/2026
Last Update Date	:	01/12/2026

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Directions to “ NATHANIEL LEMKE LMT” Practice Location

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