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Reggy Nelson

Massage Therapist

Respiratory, Developmental, Rehabilitative and Restorative Service Providers

28815 Pacific Hwy S Ste 6, Federal Way, WA 98003-3876

PECOS Enrollment

Based on the most recent information from CMS, provider Reggy Nelson does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1215256672
Provider Type
Individual
Full Name
Nelson, Reggy
Credential
LMP

Gender
Male
Sole Proprietor
No
Enumeration Date
5/25/2010
Last Updated
5/25/2010

Contact Information

Practice Location

28815 Pacific Hwy S Ste 6, Federal Way, WA 98003-3876

(253) 941-6977

Unlisted Fax

Mailing Location

28815 Pacific Hwy S Ste 6, Federal Way, WA 98003-3876

(253) 941-6977

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 225700000X Primary	Description Massage Therapist Respiratory, Developmental, Rehabilitative and Restorative Service Providers	License MA60115994 Washington

Provider Identifiers

ID	Description	Issuer
ID 1154593937	Description Other	Issuer GROUP NPI Washington

Reggy Nelson

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

Williams, Katie Elizabeth

Shelton, Steve Kent

Pierce, Jessica

Sing, Jamey

Williams, Shanelle A

Hicks, Patrina

Smith, Touraan Marque

Dofredo, Christine

Anderson, Sharese

Ilnitsky, Lily