Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

MR. CHARLES WALLACE NIESEN III, LMP

Active Sole Proprietor

MR. CHARLES WALLACE NIESEN III, LMP is a Massage Therapist healthcare provider located in PORT ORCHARD, Washington. NPI 1407048903 is currently active in the NPPES registry. Verify at CMS.

Massage Therapist · PORT ORCHARD, WA

Registration Details

NPI Number: 1407048903
Provider Type: Individual
Gender: Male
NPI Issued: Aug 17, 2007 (18.967778176418 yrs)
Last Updated: Aug 17, 2007
License: MA00018507 (WA)
Sole Proprietor: Yes

Practice Information

Address: 7950 STATE HIGHWAY 3 SW

PORT ORCHARD, WA, 983679149
Browse WA providers · Browse ZIP 98367
Phone: 3608011295
Primary Specialty: Massage Therapist
225700000X

Other Massage Therapist Providers in PORT ORCHARD, WA

Name	Credential	NPI
MR. RONALD EUGENE MOGENSEN	LMP	1942216155
STEPHANIE S FORSBERG	L.M.P.	1578570602
HILARY JANE ERNST	LMP	1679620959
OLGA OSBORN	LMP	1326191388
MRS. AUBRIANNE MICHELLE SCHNEIDERMAN	L.M.P.	1821144742
ARIN M D'AVINO	LMP	1003952789

Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.