NPIMap

Organization Active NPI

Monroe Therapeutic Massage PS

  • Massage Therapist
  • Issaquah, WA
National Provider Identifier
1104103357
Registry record updated Mar 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
Legal business name
MONROE THERAPEUTIC MASSAGE PS
Practice address
751 NE Blakely Dr
Issaquah, WA 98029-6201
Phone
(425) 455-0088
Fax
(425) 455-0340
NPI assigned
Nov 15, 2011
Last updated
Mar 13, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2013

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
(425) 802-1382

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 NU Primary

Addresses

Primary practice location

751 NE Blakely Dr
Issaquah, WA 98029-6201

Mailing address

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

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.

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": "1321315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1363132800000",
    "number": "1104103357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 E MAIN ST",
            "address_2": "STE 201",
            "city": "MONROE",
            "state": "WA",
            "postal_code": "982721519",
            "telephone_number": "360-863-0642",
            "fax_number": "360-794-7236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "751 NE BLAKELY DR",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980296201",
            "telephone_number": "425-455-0088",
            "fax_number": "425-455-0340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONROE THERAPEUTIC MASSAGE PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-15",
        "last_updated": "2013-03-13",
        "status": "A",
        "authorized_official_last_name": "DESMOND",
        "authorized_official_first_name": "GLYN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "425-802-1382",
        "authorized_official_credential": "LMP"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Issaquah, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2013; 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.