Provider Demographics
NPI:1760925416
Name:ROJAS MIERES, NELSON DANIEL (PT)
Entity Type:Individual
Prefix:
First Name:NELSON
Middle Name:DANIEL
Last Name:ROJAS MIERES
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5910 CHEROKEE LOOP SE
Mailing Address - Street 2:
Mailing Address - City:LACEY
Mailing Address - State:WA
Mailing Address - Zip Code:98513-6205
Mailing Address - Country:US
Mailing Address - Phone:360-915-7369
Mailing Address - Fax:360-688-7499
Practice Address - Street 1:4770 YELM HWY SE
Practice Address - Street 2:
Practice Address - City:LACEY
Practice Address - State:WA
Practice Address - Zip Code:98503-4986
Practice Address - Country:US
Practice Address - Phone:360-915-7369
Practice Address - Fax:360-688-7499
Is Sole Proprietor?:No
Enumeration Date:2016-11-29
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT60543040225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist