MEDICARE: PAKE R. NIELSON 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	27782	OR

General Provider Information

NPI Number	:	1750068920
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAKE R. NIELSON LMT

Provider Business Mailing Address
First Line	:	8532 N IVANHOE ST STE 201
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97203-4827
Country	:	US
Telephone Number	:	503-567-5880
Fax Number	:

Provider Business Practice Location Address
First Line	:	7318 N LEAVITT AVE
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97203-4840
Country	:	US
Telephone Number	:	503-567-5880
Fax Number	:	866-629-1294

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

Provider Enumeration Date	:	06/29/2023
Last Update Date	:	04/23/2025

Similar Medicare Providers

1912861980 — JACKSON SOMERVILLE LMT
Practice Location Address:

7318 N LEAVITT AVE
PORTLAND, OR
97203-4840

Practice Phone: 503-567-5880
Practice Fax: 866-629-1294

1023200425 — MEGAN ELIZABETH ROOD LMT, BS
Practice Location Address:

7318 N LEAVITT AVE
PORTLAND, OR
97203-4840

Practice Phone: 503-567-5880
Practice Fax:

1477302495 — BLUE FOOT HEALING LLC
Practice Location Address:

7318 N LEAVITT AVE
PORTLAND, OR
97203-4840

Practice Phone: 503-567-5880
Practice Fax: 866-629-1294

1245052935 — CHAYA COPENING LMT
Practice Location Address:

7318 N LEAVITT AVE STE 102
PORTLAND, OR
97203-4840

Practice Phone: 503-462-6456
Practice Fax:

1447073598 — SOULSTICE LLC
Practice Location Address:

7318 N LEAVITT AVE STE 101
PORTLAND, OR
97203-4840

Practice Phone: 503-462-6456
Practice Fax:

1316762552 — OREGON LIMB & BRACE LLC
Practice Location Address:

7318 N LEAVITT AVE UNIT 102
PORTLAND, OR
97203-4840

Practice Phone: 570-433-1236
Practice Fax:

Directions to “ PAKE R. NIELSON LMT” 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 © 2007-2025 (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.