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General NPI Number Information
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NPI Number | 1326218181
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Entity Type | Individual
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Provider Name | RUE HETHER NELSON L.M.T.
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Gender | Female
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Dates
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Enumeration Date | 03/08/2008
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Last Update Date | 12/11/2023
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Provider Practice Location Address
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Address Line | 2375 LOWER RIVER RD
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City | GRANTS PASS
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State | OR
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Zip | 97526-9020
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Country | US
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Telephone | 458-229-0304
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Fax |
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Provider Business Mailing Address
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Address Line | 560 NE F ST STE A PMB 459
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City | GRANTS PASS
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State | OR
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Zip | 97526-5124
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Country | US
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Telephone | 458-229-0304
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 12191
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License Number State | OR
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