Individual
NATHAN TIO LEVINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT, MAT, PT
Contact information
Practice address
800 KING ST SPC 1, POWERS, OR 97466-9691
(509) 322-4897
Mailing address
800 KING STREET, SPACE 1 BOX 396, POWERS, OR 97466
(509) 322-4897
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
25035
OR
Other
Enumeration date
11/12/2019
Last updated
05/02/2023
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