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Individual
MS. KATHLEEN DIANE NIELSON
Active
Individual
MS. KATHLEEN DIANE NIELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICENSED MASSAGE PRA
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA5015
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5829693
AETNA USHC
—
01
—
63212
LABOR & INDUSTRIES
WA
01
—
NI6014
REGENCE BLUE SHIELD
—
Enumeration date
11/24/2006
Last updated
07/08/2007
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