Mirror Images of Beauty Inc

Primary specialty

Massage TherapistTaxonomy code 225700000X

Legal business name

MIRROR IMAGES OF BEAUTY INC

Practice address

207 Allen St
Kelso, WA 98626-3403

Phone

(360) 575-9311

NPI assigned

Oct 11, 2016

Organization subpart

No

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

Authorized official

Name

Rita Elaine Nelsonsmith

Title

V.P.

Phone

(360) 749-2741

Specialties & licenses 1

Addresses

Other names 1

• Mirror Images Other name

Locations

Practitioners 1

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

• Teresea Joann Carson, LMP

  • Specialist
  • Kelso, WA
  • NPI 1720352156
  NPD (past)

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

{
    "created_epoch": "1476144000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476144000000",
    "number": "1669922845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207 ALLEN ST",
            "city": "KELSO",
            "state": "WA",
            "postal_code": "986263403",
            "telephone_number": "360-575-9311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 ALLEN ST",
            "city": "KELSO",
            "state": "WA",
            "postal_code": "986263403",
            "telephone_number": "360-575-9311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIRROR IMAGES OF BEAUTY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-11",
        "last_updated": "2016-10-11",
        "status": "A",
        "authorized_official_last_name": "NELSONSMITH",
        "authorized_official_first_name": "RITA",
        "authorized_official_middle_name": "ELAINE",
        "authorized_official_title_or_position": "V.P.",
        "authorized_official_telephone_number": "360-749-2741"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Massage Therapist",
            "state": "WA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mirror Images",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• John Duffin McShane II, MA
• Nikita Dawn Mendez, CDPT
• Scott C Miller
• Minardi Surgical PLLC
• Jessie J Minardi, MSN, RNFA
• Rama Mitchell Jr., SUDP
• Brenda Moore
• Maya Rene Moore, LICSW
• Brennnan Leigh Morrow, PHARM.D/ RP.H
• Raven Mosley

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2016; 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.