Organization Active NPI

Glamour and Grace Aesthetics LLC

  • Other Specialist/Technologist
  • Wood Village, OR
National Provider Identifier
1174465348
Registry record updated Apr 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Other Specialist/TechnologistTaxonomy code 246Z00000X
Legal business name
GLAMOUR AND GRACE AESTHETICS LLC
Practice address
1110 NE Wood Village Blvd
Wood Village, OR 97060-2668
Phone
(833) 660-7465
Fax
(312) 600-4447
NPI assigned
Apr 7, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2026

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

Authorized official

Name
Ann-Marie SegarraNPI 1801738075
Title
Owner
Phone
(833) 660-7465

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Other Specialist/TechnologistGroup: 193400000X SINGLE SPECIALTY GROUP 246Z00000X Primary

Addresses

Primary practice location

1110 NE Wood Village Blvd
Wood Village, OR 97060-2668

Mailing address

1110 NE Wood Village Blvd
Wood Village, OR 97060-2668
Phone (833) 660-7465

National Provider Directory

National Provider Directory

Locations

1110 NE Wood Village Blvd
Wood Village, OR 97060
Phone (626) 310-7465

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1775520000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1775520000000",
    "number": "1174465348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1110 NE WOOD VILLAGE BLVD",
            "city": "WOOD VILLAGE",
            "state": "OR",
            "postal_code": "970602668",
            "telephone_number": "833-660-7465",
            "fax_number": "312-600-4447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 NE WOOD VILLAGE BLVD",
            "city": "WOOD VILLAGE",
            "state": "OR",
            "postal_code": "970602668",
            "telephone_number": "833-660-7465",
            "fax_number": "312-600-4447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLAMOUR AND GRACE AESTHETICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-04-07",
        "last_updated": "2026-04-07",
        "certification_date": "2026-04-07",
        "status": "A",
        "authorized_official_last_name": "SEGARRA",
        "authorized_official_first_name": "ANN-MARIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "833-660-7465"
    },
    "taxonomies": [
        {
            "code": "246Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist/Technologist, Other",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wood Village, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2026; 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.