Active NPI
Glamour and Grace Aesthetics LLC
- Other Specialist/Technologist
- Wood Village, OR
National Provider Identifier
1174465348
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Other Specialist/Technologist
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ann-Marie Segarra
- 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) | Code | License | State | Primary |
|---|---|---|---|---|
| Other Specialist/Technologist | 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 DirectoryLocations
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.
-
- Other Specialist/Technologist
- Wood Village, OR
- NPI 1801738075
Specialist/Technologist, Other
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.