Individual provider Active NPI

Bobby Marcelino Gregory

  • Massage Therapist
  • Spokane Valley, WA
National Provider Identifier
1104730324
Registry record updated Oct 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
Practice address
2312 N Cherry St Ste 100
Spokane Valley, WA 99216-2852
Phone
(509) 863-6174
NPI assigned
Oct 2, 2026
Last updated
Oct 2, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X NU Primary

Addresses

Primary practice location

2312 N Cherry St Ste 100
Spokane Valley, WA 99216-2852

Mailing address

12702 W 4TH Ave
Airway Heights, WA 99001-5086
Phone (619) 863-3895

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1790899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790899200000",
    "number": "1104730324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12702 W 4TH AVE",
            "city": "AIRWAY HEIGHTS",
            "state": "WA",
            "postal_code": "990015086",
            "telephone_number": "619-863-3895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2312 N CHERRY ST STE 100",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "992162852",
            "telephone_number": "509-863-6174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREGORY",
        "first_name": "BOBBY",
        "middle_name": "MARCELINO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-10-02",
        "last_updated": "2026-10-02",
        "certification_date": "2026-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane Valley, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.