Pake R. Nielson, LMT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

27782 Issued in OR

Practice address

7318 N Leavitt Ave
Portland, OR 97203-4840

Phone

(503) 567-5880

Fax

(866) 629-1294

NPI assigned

Jun 29, 2023

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

Credentials

Master of Theology

State licenses

Practice roles

Locations

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

• Blue Foot Healing LLC

  • Massage Therapist
  • Portland, OR
  • NPI 1477302495
  NPD Authorized official

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

{
    "created_epoch": "1687996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745366400000",
    "number": "1750068920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8532 N IVANHOE ST STE 201",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972034827",
            "telephone_number": "503-567-5880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7318 N LEAVITT AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972034840",
            "telephone_number": "503-567-5880",
            "fax_number": "866-629-1294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIELSON",
        "first_name": "PAKE",
        "middle_name": "R.",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-06-29",
        "last_updated": "2025-04-23",
        "certification_date": "2025-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "OR",
            "license": "27782",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sara Nielsen
• Nielson Nutrition & Diabetes Care
• Griffin Leigh Nielson-Smith, LPC ASSOCIATE, NCC
• Ariela Nielson, RD
• Darcy Nielson, CCC-SLP
• Steven E Nielson, PA
• Carol L Nieman
• Caleb James Niemetchek
• Jennifer Niemeyer, RD
• Cassandra Michelle Niemi, MD

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2025; 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.