Glen Andrew Collen, LMT5268 LAC GC579

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

LMT5268 Issued in HI

Practice address

1051 Keolu Dr
Enchanted Lakes Massage Clinic Suite 104
Kailua, HI 96734

Phone

(808) 262-6563

NPI assigned

Jun 12, 2007

Last updated

Sep 11, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1181606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1275737520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "449 KAILUA RD",
            "address_2": "C3",
            "city": "KAILUA",
            "state": "HI",
            "postal_code": "96734",
            "telephone_number": "808-261-1024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1051 KEOLU DR",
            "address_2": "ENCHANTED LAKES MASSAGE CLINIC SUITE 104",
            "city": "KAILUA",
            "state": "HI",
            "postal_code": "96734",
            "telephone_number": "808-262-6563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLEN",
        "first_name": "GLEN",
        "middle_name": "ANDREW",
        "name_prefix": "Mr.",
        "credential": "LMT5268 LAC GC579",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-12",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "HI",
            "license": "579LAC",
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "HI",
            "license": "LMT5268",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Massage Therapist in Kailua, HI
• Providers in Kailua, HI by specialty
• Massage Therapist in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 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.