Provider Demographics
NPI:1427426634
Name:NASH, STEVEN A (LMP)
Entity type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:A
Last Name:NASH
Suffix:
Gender:M
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:445 E CEDAR BLVD
Mailing Address - Street 2:SUITE C
Mailing Address - City:OTHELLO
Mailing Address - State:WA
Mailing Address - Zip Code:99344-1107
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:445 E CEDAR BLVD
Practice Address - Street 2:SUITE C
Practice Address - City:OTHELLO
Practice Address - State:WA
Practice Address - Zip Code:99344-1107
Practice Address - Country:US
Practice Address - Phone:509-331-6308
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-03
Last Update Date:2015-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60294358225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist