Provider Demographics
NPI:1477678662
Name:MORTON NELSON, HOPE MURIEL (LMP 19373)
Entity Type:Individual
Prefix:MS
First Name:HOPE
Middle Name:MURIEL
Last Name:MORTON NELSON
Suffix:
Gender:F
Credentials:LMP 19373
Other - Prefix:MS
Other - First Name:HOPE
Other - Middle Name:MURIEL
Other - Last Name:MORTON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMT 19373
Mailing Address - Street 1:PO BOX 1405
Mailing Address - Street 2:
Mailing Address - City:ENUMCLAW
Mailing Address - State:WA
Mailing Address - Zip Code:98022-1405
Mailing Address - Country:US
Mailing Address - Phone:253-318-3523
Mailing Address - Fax:360-825-5967
Practice Address - Street 1:2944 GRIFFIN AVE
Practice Address - Street 2:
Practice Address - City:ENUMCLAW
Practice Address - State:WA
Practice Address - Zip Code:98022-2366
Practice Address - Country:US
Practice Address - Phone:253-318-3523
Practice Address - Fax:360-825-5967
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2019-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA19373225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA404016-00OtherNATIONAL CERTIFICATION BOARD FOR THERAPEUTIC MASSAGE AND BODYWORK
WAMA00019373OtherWA STATE DEPT OF HEALTH