NPIMap

Organization Active NPI

Relax Mind & Body Massage PLLC

  • Massage Therapist
  • Arlington, WA
National Provider Identifier
1255979837
Registry record updated Jan 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
Legal business name
RELAX MIND & BODY MASSAGE PLLC
Practice address
3710 168TH St NE Ste B102
Arlington, WA 98223-8463
Phone
(360) 631-9965
Fax
(360) 322-6606
NPI assigned
Dec 14, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2023

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

Authorized official

Name
Ms. Shannon Michelle Ingrum, LMTNPI 1265791750
Title
Owner/LMT
Phone
(360) 631-9965

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
AcupuncturistGroup: 193200000X MULTI-SPECIALTY GROUP 171100000X
Massage TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225700000X Primary

Addresses

Primary practice location

3710 168TH St NE Ste B102
Arlington, WA 98223-8463

Mailing address

3710 168TH St NE Ste B102
Arlington, WA 98223-8463
Phone (360) 631-9965

Other names 1

  • Shannon Ingrum, LMT Former legal business name

National Provider Directory

National Provider Directory

Locations

3710 168th St NE
Ste B206
Arlington, WA 98223

Practitioners & affiliated clinicians

Practitioners 5

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": "1576281600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1672876800000",
    "number": "1255979837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3710 168TH ST NE STE B102",
            "city": "ARLINGTON",
            "state": "WA",
            "postal_code": "982238463",
            "telephone_number": "360-631-9965",
            "fax_number": "360-322-6606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3710 168TH ST NE STE B102",
            "city": "ARLINGTON",
            "state": "WA",
            "postal_code": "982238463",
            "telephone_number": "360-631-9965",
            "fax_number": "360-322-6606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RELAX MIND & BODY MASSAGE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-14",
        "last_updated": "2023-01-05",
        "certification_date": "2023-01-05",
        "status": "A",
        "authorized_official_last_name": "INGRUM",
        "authorized_official_first_name": "SHANNON",
        "authorized_official_middle_name": "MICHELLE",
        "authorized_official_title_or_position": "OWNER/LMT",
        "authorized_official_telephone_number": "360-631-9965",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LMT"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Acupuncturist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Massage Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shannon Ingrum, LMT",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Shannon Ingrum, LMT",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Arlington, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2023; 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.