Individual provider Active NPI

Gloria McNelly, LMT

  • Massage Therapist
  • Spokane Valley, WA
National Provider Identifier
1558150334
Registry record updated May 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA61478564 Issued in WA
Practice address
12121 E Broadway Ave Ste 5B
Spokane Valley, WA 99206-4972
Phone
(509) 921-9800
NPI assigned
May 6, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2025

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 MA61478564 WA Primary

Addresses

Primary practice location

12121 E Broadway Ave Ste 5B
Spokane Valley, WA 99206-4972

Mailing address

10915 E Empire Ave
Spokane Valley, WA 99206-4575
Phone (509) 999-0591

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
MA61478564WAMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1746489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746489600000",
    "number": "1558150334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10915 E EMPIRE AVE",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "992064575",
            "telephone_number": "509-999-0591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12121 E BROADWAY AVE STE 5B",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "992064972",
            "telephone_number": "509-921-9800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCNELLY",
        "first_name": "GLORIA",
        "credential": "LMT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-05-06",
        "last_updated": "2025-05-06",
        "certification_date": "2025-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": "MA61478564",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane Valley, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 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.