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NPI Code Detail

MEDICARE: JESSICA MARIN NELSON LMP

MEDICARE: JESSICA MARIN NELSON LMP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225700000XMassage TherapistMA60468041WA

General Provider Information

NPI Number : 1033526926
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA MARIN NELSON LMP
Provider Business Mailing Address
First Line : 8401 16TH AVE SW
Second Line :
City : SEATTLE
State : WA
Zip : 98106-2365
Country : US
Telephone Number : 253-677-6590
Fax Number :
Provider Business Practice Location Address
First Line : 5236 CALIFORNIA AVE SW STE D
Second Line :
City : SEATTLE
State : WA
Zip : 98136-1283
Country : US
Telephone Number : 206-331-3999
Fax Number : 206-388-3226
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/13/2014
Last Update Date : 07/13/2014

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Directions to “ JESSICA MARIN NELSON LMP” Practice Location

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