The Spa at Pacific Wellness, LLC

Primary specialty

Massage TherapistTaxonomy code 225700000X

Legal business name

THE SPA AT PACIFIC WELLNESS, LLC

Practice address

4114 Bridgeport Way W
University Place, WA 98466-4303

Phone

(253) 564-4508

Fax

(253) 564-8387

NPI assigned

Aug 30, 2011

Last updated

Aug 30, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Edward Dean Corley, DCNPI 1821151820

Title

Chiropractor/Owner

Phone

(253) 564-8100

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Edward D Corley, DC

  • Rehabilitation Chiropractor
  • University Place, WA
  • NPI 1821151820
  Authorized official Same address or phone

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

{
    "created_epoch": "1314662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1314662400000",
    "number": "1972884302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4114 BRIDGEPORT WAY W",
            "city": "UNIVERSITY PLACE",
            "state": "WA",
            "postal_code": "984664303",
            "telephone_number": "253-564-4508",
            "fax_number": "253-564-8387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4114 BRIDGEPORT WAY W",
            "city": "UNIVERSITY PLACE",
            "state": "WA",
            "postal_code": "984664303",
            "telephone_number": "253-564-4508",
            "fax_number": "253-564-8387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE SPA AT PACIFIC WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-30",
        "last_updated": "2011-08-30",
        "status": "A",
        "authorized_official_last_name": "CORLEY",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "DEAN",
        "authorized_official_title_or_position": "CHIROPRACTOR/OWNER",
        "authorized_official_telephone_number": "253-564-8100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Massage Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Keren Elizabeth Virginia Tangen, M.S.W.
• Alejandro Antonio Tavira, CG 60475423
• Douglas Carpenter Taylor, L.M.P.
• Julia Taylor, MD
• Mollie Taylor
• Camille Alissa Thenard, DACCHM,DIPL.AC.,L.AC
• Therapeutic Associates Inc (TAI - University Place Physical Therapy)
• Therapy Management Services, PLLC (University Place Physical Therapy)
• Therapy Management Services, PLLC (University Place Physical Therapy)
• Caleb Paul Thomas, DPM

• Massage Therapist in University Place, WA
• Providers in University Place, WA by specialty
• Massage Therapist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2011; 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.