Healthcare Provider Details

I. General information

NPI: 1982031605
Provider Name (Legal Business Name): HANNAH NELSON LMP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/27/2013
Last Update Date: 09/27/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

136 E JOHNSON AVE STE 1
CHELAN WA
98816-1890
US

IV. Provider business mailing address

PO BOX 1890
CHELAN WA
98816-1890
US

V. Phone/Fax

Practice location:
  • Phone: 509-888-5477
  • Fax: 509-888-5352
Mailing address:
  • Phone: 509-888-5477
  • Fax: 509-888-5352

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMA60391392
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: