Provider Demographics
NPI:1952608606
Name:NELSON'S INTERIOR
Entity Type:Organization
Organization Name:NELSON'S INTERIOR
Other - Org Name:MASSAGE ENVY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CARRIE
Authorized Official - Middle Name:M
Authorized Official - Last Name:NORRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:506-653-0400
Mailing Address - Street 1:9895 SE SUNNYSIDE RD
Mailing Address - Street 2:
Mailing Address - City:CLACKAMAS
Mailing Address - State:OR
Mailing Address - Zip Code:97015-5740
Mailing Address - Country:US
Mailing Address - Phone:503-653-0400
Mailing Address - Fax:503-653-5146
Practice Address - Street 1:9895 SE SUNNYSIDE RD
Practice Address - Street 2:
Practice Address - City:CLACKAMAS
Practice Address - State:OR
Practice Address - Zip Code:97015-5740
Practice Address - Country:US
Practice Address - Phone:503-653-0400
Practice Address - Fax:503-653-5146
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-15
Last Update Date:2011-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty