Body Reflects LLC

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MA00022371 Issued in WA

Legal business name

BODY REFLECTS LLC

Practice address

1631 15TH Ave W Ste 308
Seattle, WA 98119-2796

Phone

(206) 679-0111

NPI assigned

Oct 9, 2017

Organization subpart

No

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

Authorized official

Name

Mrs. Carlie Bae, LMT

Title

Owner

Phone

(206) 679-0111

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1507507200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1507507200000",
    "number": "1104336791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1631 15TH AVE W STE 308",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981192796",
            "telephone_number": "206-679-0111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1631 15TH AVE W STE 308",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981192796",
            "telephone_number": "206-679-0111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BODY REFLECTS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-09",
        "last_updated": "2017-10-09",
        "status": "A",
        "authorized_official_last_name": "BAE",
        "authorized_official_first_name": "CARLIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "206-679-0111",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LMT"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA00022371",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1336695816",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1104232735",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Massage Therapist in Seattle, WA
• Providers in Seattle, WA by specialty
• Massage Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2017; 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.