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NPI Code Detail

MEDICARE: JESSE HUDSON LMT

MEDICARE:   JESSE  HUDSON  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
1225700000XMassage Therapist11325OR

General Provider Information

NPI Number : 1821952771
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSE HUDSON LMT
Provider Business Mailing Address
First Line : 6360 SW BEAVERTON HILLSDALE HWY
Second Line :
City : PORTLAND
State : OR
Zip : 97221-4223
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 19355 SW MOHAVE CT
Second Line :
City : TUALATIN
State : OR
Zip : 97062-8631
Country : US
Telephone Number : 503-486-5199
Fax Number : 503-486-5190
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/15/2025
Last Update Date : 12/15/2025

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Directions to “ JESSE HUDSON LMT” Practice Location

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