Serene Rejuvenation Massage Therapy, L.L.C.

Primary specialty

Massage TherapistTaxonomy code 225700000X

Legal business name

SERENE REJUVENATION MASSAGE THERAPY, L.L.C.

Practice address

21715 103Rd Avenue CT E
Suite # D-401
Graham, WA 98338-8152

Phone

(253) 262-3118

Fax

(253) 262-3133

NPI assigned

Jun 25, 2012

Organization subpart

No

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

Authorized official

Name

Colleen Marie Smith, L.M.P.

Title

Owner

Phone

(253) 262-3118

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1340582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1340582400000",
    "number": "1306100391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21715 103RD AVENUE CT E",
            "address_2": "SUITE # D-401",
            "city": "GRAHAM",
            "state": "WA",
            "postal_code": "983388152",
            "telephone_number": "253-262-3118",
            "fax_number": "253-262-3133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21715 103RD AVENUE CT E",
            "address_2": "SUITE # D-401",
            "city": "GRAHAM",
            "state": "WA",
            "postal_code": "983388152",
            "telephone_number": "253-262-3118",
            "fax_number": "253-262-3133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERENE REJUVENATION MASSAGE THERAPY, L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-25",
        "last_updated": "2012-06-25",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "COLLEEN",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "253-262-3118",
        "authorized_official_credential": "L.M.P."
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Massage Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2012; 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.