Provider Demographics
NPI:1275752909
Name:NELSON, REID VERYL (DC)
Entity Type:Individual
Prefix:DR
First Name:REID
Middle Name:VERYL
Last Name:NELSON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16812 140TH AVE NE
Mailing Address - Street 2:#B
Mailing Address - City:WOODINVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98072
Mailing Address - Country:US
Mailing Address - Phone:425-483-5110
Mailing Address - Fax:425-481-6074
Practice Address - Street 1:16812 140TH AVE NE
Practice Address - Street 2:#B
Practice Address - City:WOODINVILLE
Practice Address - State:WA
Practice Address - Zip Code:98072
Practice Address - Country:US
Practice Address - Phone:425-483-5110
Practice Address - Fax:425-481-6074
Is Sole Proprietor?:No
Enumeration Date:2007-04-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA1714111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor