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Mr. Charles Wallace Niesen III, LMP
Massage Therapist in Port Orchard, Washington
NPI 1407048903

Charles Wallace Niesen III is a Massage Therapist based in Belfair, WA. Charles Wallace Niesen III practices in Port Orchard, WA and has the professional credentials of LMP. The NPI Number for Charles Wallace Niesen III is 1407048903 and holds a License No. MA00018507 (Washington).

The current practice location address for Charles Wallace Niesen III is 7950 State Highway 3 Sw, Port Orchard, WA and can be reached out via phone at 360-801-1295.

Location: 7950 State Highway 3 Sw, Port Orchard, WA, 98528-0252
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1407048903
Provider Name
Charles Wallace Niesen III
Credential
LMP
Provider Entity Type
Individual
Gender
Male
Address
7950 State Highway 3 Sw, Port Orchard, WA, 98528-0252
Phone Number
360-801-1295
Fax Number
Provider Enumeration Date
08/17/2007
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
7950 State Highway 3 Sw
City
Port Orchard
State
Washington
Zip
98367-9149
Phone Number
360-801-1295
Fax Number
person
Provider Business Mailing Address Details
Address
7950 State Highway 3 Sw
City
Port Orchard
State
Washington
Zip
98367-9149
Phone Number
360-801-1295
Fax Number
person
Provider's Taxonomy Details 1
Type
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Classification
Massage Therapist
Speciality
-
Taxonomy
225700000X
License No.
MA00018507 (Washington)
Definition
An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes.
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