MEDICARE: MR. NEERA JAKOB NAYAR LMT

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
1	225700000X	Massage Therapist	MASS.MA.61399536	WA

General Provider Information

NPI Number	:	1104799360
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. NEERA JAKOB NAYAR LMT

Provider Business Mailing Address
First Line	:	7218 HUSKY WAY SE
Second Line	:
City	:	OLYMPIA
State	:	WA
Zip	:	98503-6716
Country	:	US
Telephone Number	:	360-777-6994
Fax Number	:

Provider Business Practice Location Address
First Line	:	1217 4TH AVE E STE 101
Second Line	:
City	:	OLYMPIA
State	:	WA
Zip	:	98506-4246
Country	:	US
Telephone Number	:	360-777-6994
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/24/2025
Last Update Date	:	09/24/2025

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