Chantel Louise Nelson, LMP, ACSM
Individual provider Active NPI Specialist · Westport, WA
NPI 1497905152 · NPPES record last updated Jan 21, 2011
Key facts
- NPI
- 1497905152
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Specialist 174400000X
- License
- MA00016401 (WA)
- Practice address
- 722 N Montesano Street
Westport, WA 98595 - Phone
- (360) 500-9970
- NPI assigned
- Sep 30, 2008
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA00016401 | WA | MD | Specialist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | MA00016401 | WA | Yes |
Addresses
Primary practice location
722 N Montesano Street
Westport, WA 98595
Mailing address
PO Box 968
Westport, WA 98595-0968
Phone (360) 500-9970
Other providers in Westport, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 21, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.