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Contact Information

NICOLE M GLEESON, LMP
330 PIONEER AVE
MONTESANO, WA98563
 Phone: 360-580-1667
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Mechanotherapist

172M00000X
Indicates primary specialty

NPI Profile & details for NICOLE M GLEESON · (Female)

NPI # 1487986915
Status Active
Credentials LMP (Licensed Medical Practitioner)
Entity Individual
Enumeration date 02/09/2010
Last updated 04/27/2020 - About 6 years ago
Sole proprietor 1 Yes
Identifiers
  • WA License # MA60112062
  • WA Other MA60112062 WA STATE MASSAGE LICENSE NUMBER
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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