Provider Demographics
NPI:1275184418
Name:SILVEIRA, NATALIE ANNETTE (LMT)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:ANNETTE
Last Name:SILVEIRA
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11847 RIDGE PKWY APT 115
Mailing Address - Street 2:
Mailing Address - City:BROOMFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:80021-5088
Mailing Address - Country:US
Mailing Address - Phone:720-391-8649
Mailing Address - Fax:
Practice Address - Street 1:11890 W 64TH AVE
Practice Address - Street 2:
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80004-4324
Practice Address - Country:US
Practice Address - Phone:303-467-5337
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-27
Last Update Date:2019-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COMT.0009012225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist