Individual
MR. NATHAN JOHN NORDSTROM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
270 NE 181ST AVE, PORTLAND, OR 97230-6663
(503) 669-1966
Mailing address
PO BOX 3101, GRESHAM, OR 97030-0323
(503) 706-2480
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
7700
OR
Other
Enumeration date
12/18/2006
Last updated
07/08/2007
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