Nicholas Ryan Wilson, LMT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

27466 Issued in OR

Practice address

4250 SW 182ND Ave
Beaverton, OR 97078-1650

Phone

(503) 764-7595

NPI assigned

Aug 1, 2024

Last updated

Aug 1, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Nicholas Wilson

  • Massage Therapist
  • Beaverton, OR
  • NPI 1215827886
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1722470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722470400000",
    "number": "1326878711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4250 SW 182ND AVE",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970781650",
            "telephone_number": "503-764-7595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4250 SW 182ND AVE",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970781650",
            "telephone_number": "503-764-7595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "NICHOLAS",
        "middle_name": "RYAN",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-08-01",
        "last_updated": "2024-08-01",
        "certification_date": "2024-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "OR",
            "license": "27466",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Willow Path Recovery LLC
• Bryon Willson, LMT
• Christina Lee Wilson, RDH,BSDH
• Jennifer Michelle Wilson, PT, DPT
• Jessica L Wilson, DO
• Stacey L Wilson, CNM
• Victor A Wilson, DPT
• Caelie Jaye Winchester
• Windrose Group Home LLC
• Lindsey Wineland

• Massage Therapist in Beaverton, OR
• Providers in Beaverton, OR by specialty
• Massage Therapist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.