Doctor Name: | MR. ISAAC EMMANUEL NELSON |
NPI Number: | 1629387568 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LMP |
License Number: | MA 60103770 |
Business Practice Address: | 1455 Columbia Park Trl Suite 102 Richland, WA - 993524711 |
Business Phone Number: | 5093963707 |
Business Fax Number: | 5093963710 |
Mailing Address: | 1455 Columbia Park Trl, Suite 102 RICHLAND |
State: | WA |
Postal Code: | 993524711 |
Phone Number: | 5093963707 |
Fax Number: | 5093963710 |
NPI Enumeration Date: | 09/27/2010 |
NPI Last Update Date: | 09/27/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225700000X |
License Number: | MA 60103770 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WA |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Massage Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. |