Glisten Tanning Spa & Salon, LLC

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

MA60523229 Issued in WA

Legal business name

GLISTEN TANNING SPA & SALON, LLC

Practice address

5603 Summitview Ave Ste 100
Yakima, WA 98908-3018

Phone

(509) 895-7383

Fax

(509) 895-7739

NPI assigned

Jan 22, 2018

Organization subpart

No

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

Authorized official

Name

Nicole Reyes, LMP

Title

President, LMP

Phone

(509) 895-7383

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Glisten Tanning Spa & Salon Doing business as

Locations

Practitioners 1

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

• Summer J Kirby, LMP

  • Massage Therapist
  • Yakima, WA
  • NPI 1083270532
  NPD (past)

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

{
    "created_epoch": "1516579200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1516579200000",
    "number": "1356859540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8051",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989080051",
            "telephone_number": "509-469-1903",
            "fax_number": "509-469-1905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5603 SUMMITVIEW AVE STE 100",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989083018",
            "telephone_number": "509-895-7383",
            "fax_number": "509-895-7739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLISTEN TANNING SPA & SALON, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-22",
        "last_updated": "2018-01-22",
        "status": "A",
        "authorized_official_last_name": "REYES",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "PRESIDENT, LMP",
        "authorized_official_telephone_number": "509-895-7383",
        "authorized_official_credential": "LMP"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA60523229",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UBI",
            "identifier": "604042951",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Glisten Tanning Spa & Salon",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kim Glasenapp
• Brittani Glaspey
• Kathleen Ann Glaspey
• William J Glenski, M.D.
• David Glesener
• George Go
• Brandon Wallace Godfrey, M.D.
• Natasha K Godines
• Nelida Noemi Godinez Mojica
• Diana A Godinez

• Massage Therapist in Yakima, WA
• Providers in Yakima, WA by specialty
• Massage Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2018; 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.