Individual
JOHN RICHARD NIELSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
509 OLIVE WAY, SUITE 1011, SEATTLE, WA 98101-1720
(206) 623-4570
(206) 623-4574
Mailing address
16083 SW UPPER BOONES FERRY RD, SUITE 300, TIGARD, OR 97224-7736
(800) 219-8835
(503) 639-9699
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
60628838
WA
225100000X
Physical Therapist
PT06294
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1508186669
—
WA
Enumeration date
06/10/2010
Last updated
03/25/2016
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