Massage Radiance

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

MA00024680 Issued in WA

Legal business name

MASSAGE RADIANCE

Practice address

2108 Riverside Dr
Mount Vernon, WA 98273-5406

Phone

(360) 540-1900

NPI assigned

Sep 14, 2007

Organization subpart

No

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

Authorized official

Name

Renee C. Palmer, LMP

Title

Owner/Manager

Phone

(360) 540-1900

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1189728000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1447804800000",
    "number": "1518153378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2420 E MEADOW BLVD",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982732374",
            "telephone_number": "360-540-1900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2108 RIVERSIDE DR",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982735406",
            "telephone_number": "360-540-1900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MASSAGE RADIANCE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-14",
        "last_updated": "2015-11-18",
        "status": "A",
        "authorized_official_last_name": "PALMER",
        "authorized_official_first_name": "RENEE",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "OWNER/MANAGER",
        "authorized_official_telephone_number": "360-540-1900",
        "authorized_official_credential": "LMP"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "WA",
            "license": "MA00024680",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alejandro Martinez
• Humberto Martinez
• Marcela Lopez Martinez X
• Maria Angeles Martinez
• Diane C Marx, RDN
• Masterpeace Counseling, PLLC
• Bruce C Mathey, MD
• Susan Ruth Mathey, CDP
• Christopher Ryan Mathis, LMHC
• Abcde Matias

• Clinic/Center in Mount Vernon, WA
• Providers in Mount Vernon, WA by specialty
• Clinic/Center in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2015; 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.