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

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, DC

Title

Chiropractor/Owner

Phone

(253) 564-8100

Specialties & licenses 1

Addresses

Locations

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
• Therapy Management Services, PLLC
• Therapy Management Services, PLLC
• 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.