Diana Nelson Massage LLC

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MA60654108 Issued in WA

Legal business name

DIANA NELSON MASSAGE LLC

Practice address

401 W Main St # 105
Walla Walla, WA 99362-2837

Phone

(509) 301-3859

NPI assigned

Jun 6, 2016

Last updated

Jun 6, 2016By the provider in NPPES

Organization subpart

Yes

Parent organization

DIANA NELSON MASSAGE LLCAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Diana Jo Nelson, LMP

Title

Licensed Massage Practitioner

Phone

(509) 301-3859

Specialties & licenses 1

Addresses

Part of

Diana Nelson Massage LLC

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1465171200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1465171200000",
    "number": "1760831283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 W MAIN ST # 105",
            "city": "WALLA WALLA",
            "state": "WA",
            "postal_code": "993622837",
            "telephone_number": "509-301-3859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 W MAIN ST # 105",
            "city": "WALLA WALLA",
            "state": "WA",
            "postal_code": "993622837",
            "telephone_number": "509-301-3859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIANA NELSON MASSAGE LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DIANA NELSON MASSAGE LLC",
        "enumeration_date": "2016-06-06",
        "last_updated": "2016-06-06",
        "status": "A",
        "authorized_official_last_name": "NELSON",
        "authorized_official_first_name": "DIANA",
        "authorized_official_middle_name": "JO",
        "authorized_official_title_or_position": "LICENSED MASSAGE PRACTITIONER",
        "authorized_official_telephone_number": "509-301-3859",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LMP"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA60654108",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.