Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111NR0400X | Rehabilitation Chiropractor | CH00002066 | WA |
Y | 111NS0005X | Chiropractic Sports Physician | CH00002066 | WA |
N | 111NX0800X | Chiropractor Orthopedic Specialist | CH00002066 | WA |
NPI | 1396818324 |
---|---|
Provider Name | Daniel L. Nelson |
First Address | Seattle, WA 98105-4093 |
Second Address | Seattle, WA 98105-4093 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/11/2006 |
Last Update Date | 05/06/2014 |