Provider Demographics
NPI:1477516029
Name:RASMUSSEN, NELS WALTER (DC)
Entity Type:Individual
Prefix:DR
First Name:NELS
Middle Name:WALTER
Last Name:RASMUSSEN
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:PO BOX 845
Mailing Address - Street 2:
Mailing Address - City:DARRINGTON
Mailing Address - State:WA
Mailing Address - Zip Code:98241-0845
Mailing Address - Country:US
Mailing Address - Phone:360-436-1663
Mailing Address - Fax:
Practice Address - Street 1:1120 SEEMAN ST
Practice Address - Street 2:
Practice Address - City:DARRINGTON
Practice Address - State:WA
Practice Address - Zip Code:98241-9100
Practice Address - Country:US
Practice Address - Phone:360-436-1663
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA0001516111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAT02196Medicare UPIN