Individual
MICHELLE J NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1717 S J ST, TACOMA, WA 98405-4933
(253) 426-6341
(253) 426-6344
Mailing address
1717 S J ST, TACOMA, WA 98405-4933
(253) 426-6341
(253) 426-6344
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA10004779
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0195914
STATE L&I
WA
05
—
8427197
—
WA
01
—
8905199
STATE CRIME VICTIMS
WA
01
—
P00294398
RAILROAD
WA
Enumeration date
09/20/2006
Last updated
11/11/2010
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