Glacier Functional Therapy

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

Legal business name

GLACIER FUNCTIONAL THERAPY

Doing business as

Northern Lights Functional Therapy

Practice address

903 Spokane Ave Ste 4
Whitefish, MT 59937-2980

Phone

(406) 282-4064

NPI assigned

Feb 26, 2025

Last updated

Mar 27, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Selena Ruyi Bach, OTR/L

Title

Sole Member

Phone

(208) 610-8671

Specialties & licenses 1

Addresses

Other names 1

• Northern Lights Functional Therapy Doing business as

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

{
    "created_epoch": "1740528000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1743033600000",
    "number": "1174320295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1087",
            "city": "WHITEFISH",
            "state": "MT",
            "postal_code": "599371087",
            "telephone_number": "208-610-8671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "903 SPOKANE AVE STE 4",
            "city": "WHITEFISH",
            "state": "MT",
            "postal_code": "599372980",
            "telephone_number": "406-282-4064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLACIER FUNCTIONAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-26",
        "last_updated": "2025-03-27",
        "certification_date": "2025-03-27",
        "status": "A",
        "authorized_official_last_name": "BACH",
        "authorized_official_first_name": "SELENA",
        "authorized_official_middle_name": "RUYI",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "208-610-8671",
        "authorized_official_credential": "OTR/L"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Northern Lights Functional Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• GFC Inc
• Jordan Gilbert, MSW, SWLC
• Eric J Gislason, DC
• Kimberly Anne Givler, DPT
• Glacier Cardiovascular Consultants
• Glacier Medical Associates
• Glacier Medical Associates
• Glacier Medical Associates
• Glacier Oral and Maxillofacial Surgery PC
• Glacier Pilates and Physical Therapy, LLC

• Medical Specialty Clinic/Center in Whitefish, MT
• Providers in Whitefish, MT by specialty
• Medical Specialty Clinic/Center in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2025; 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.