Individual provider Active NPI

Gary Glenn Rhodes Jr., LMP

  • Massage Therapist
  • Seattle, WA
National Provider Identifier
1417149105
Registry record updated Aug 15, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
#MA00023439 Issued in WA
Practice address
5410 California Ave SW
Suite 203
Seattle, WA 98136-1562
Phone
(206) 331-3999
Fax
(206) 388-3226
NPI assigned
Aug 15, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 15, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X #MA00023439 WA Primary

Addresses

Primary practice location

5410 California Ave SW
Suite 203
Seattle, WA 98136-1562

Mailing address

5410 California Ave SW
Suite 203
Seattle, WA 98136-1562
Phone (206) 331-3999

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
#MA00023439WAMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1187136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1187136000000",
    "number": "1417149105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5410 CALIFORNIA AVE SW",
            "address_2": "SUITE 203",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981361562",
            "telephone_number": "206-331-3999",
            "fax_number": "206-388-3226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5410 CALIFORNIA AVE SW",
            "address_2": "SUITE 203",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981361562",
            "telephone_number": "206-331-3999",
            "fax_number": "206-388-3226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RHODES",
        "first_name": "GARY",
        "middle_name": "GLENN",
        "name_suffix": "Jr.",
        "credential": "LMP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-08-15",
        "last_updated": "2007-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "#MA00023439",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2007; 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.