NPIMap

Organization Active NPI

Monroe Therapeutic Massage

  • Massage Therapist
  • Redmond, WA
National Provider Identifier
1033522057
Registry record updated Jun 6, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA00013939 Issued in WA
Legal business name
MONROE THERAPEUTIC MASSAGE
Practice address
3925 159TH Ave NE
Building 21
Redmond, WA 98052
Phone
(425) 455-0088
NPI assigned
Jun 6, 2014
Last updated
Jun 6, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Glyn Desmond, LMPNPI 1023233814
Title
President
Phone
(360) 863-0642

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X MA00013939 WA Primary

Addresses

Primary practice location

3925 159TH Ave NE
Building 21
Redmond, WA 98052

Mailing address

101 E Main St Ste 201
Monroe, WA 98272-1519
Phone (360) 863-0642

Other names 1

  • Microsoft Living Well Health Center Other name

National Provider Directory

National Provider Directory
Tax ID family
Monroe Therapeutic Massage PS11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

Organizations that report the same tax identification number in the National Provider Directory.

Locations

3925 159th Ave NE
Bldg 21
Redmond, WA 98052
Phone (425) 216-0550

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1402012800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1402012800000",
    "number": "1033522057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 E MAIN ST STE 201",
            "city": "MONROE",
            "state": "WA",
            "postal_code": "982721519",
            "telephone_number": "360-863-0642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3925 159TH AVE NE",
            "address_2": "BUILDING 21",
            "city": "REDMOND",
            "state": "WA",
            "postal_code": "98052",
            "telephone_number": "425-455-0088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONROE THERAPEUTIC MASSAGE",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-06",
        "last_updated": "2014-06-06",
        "status": "A",
        "authorized_official_last_name": "DESMOND",
        "authorized_official_first_name": "GLYN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "360-863-0642",
        "authorized_official_credential": "LMP"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA00013939",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Microsoft Living Well Health Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Redmond, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.