Healthcare Provider Details

I. General information

NPI: 1184532376
Provider Name (Legal Business Name): NATHAN SILVA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/31/2026
Last Update Date: 08/31/2026
Certification Date: 08/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

540 W PRINCE RD STE 4
TUCSON AZ
85705-3714
US

IV. Provider business mailing address

PO BOX 65642
TUCSON AZ
85728-5642
US

V. Phone/Fax

Practice location:
  • Phone: 520-887-2228
  • Fax:
Mailing address:
  • Phone: 520-887-2228
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMT-30394
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: