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Individual

RUE HETHER NELSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
L.M.T.

Contact information

Practice address
2375 LOWER RIVER RD, GRANTS PASS, OR 97526-9020
(458) 229-0304
Mailing address
560 NE F ST, STE A PMB 459, GRANTS PASS, OR 97526-5124
(458) 229-0304

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
12191
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
12191
STATE OF OR BOARD OF MASSAGE THERAPISTS
OR
Enumeration date
03/08/2008
Last updated
12/11/2023
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