Individual provider · Type 1 NPI

Charles Wallace Niesen Iii, LMP

Massage Therapist · Port Orchard, WA

NPI number 1407048903 Active

Practice location

7950 State Highway 3 SW
Port Orchard, WA 98367-9149

Call (360) 801-1295 Map

Mailing address

PO Box 252
Belfair, WA 98528-0252

Specialties and licenses

TaxonomyCodeLicense
Massage Therapist Primary 225700000XMA00018507 (WA)

Massage Therapist: An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes.

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About NPI 1407048903

Charles Wallace Niesen Iii, LMP's National Provider Identifier is 1407048903, issued on Aug 17, 2007. The primary taxonomy on file is Massage Therapist (225700000X), and the practice location is in Port Orchard, WA. The record was last updated on Aug 17, 2007.