Provider Demographics
NPI:1588792634
Name:NOLTE, PAUL JOSEPH (LMT)
Entity type:Individual
Prefix:MR
First Name:PAUL
Middle Name:JOSEPH
Last Name:NOLTE
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
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Mailing Address - Street 1:14023 188 AVE
Mailing Address - Street 2:KPN
Mailing Address - City:GIG HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98329
Mailing Address - Country:US
Mailing Address - Phone:253-884-9327
Mailing Address - Fax:253-752-4833
Practice Address - Street 1:3502 S 12TH
Practice Address - Street 2:SUITE B
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405
Practice Address - Country:US
Practice Address - Phone:253-752-4833
Practice Address - Fax:253-752-4833
Is Sole Proprietor?:No
Enumeration Date:2007-03-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAMA00004826225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA64698OtherDEPT OF L AND I