Organization
GLISTEN TANNING SPA & SALON, LLC
Active
Other names
Glisten Tanning Spa & Salon
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLE REYES LMP (PRESIDENT, LMP)
(509) 895-7383
Entity
Organization
Contact information
Practice address
5603 SUMMITVIEW AVE STE 100, YAKIMA, WA 98908-3018
(509) 895-7383
(509) 895-7739
Mailing address
PO BOX 8051, YAKIMA, WA 98908-0051
(509) 469-1903
(509) 469-1905
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA60523229
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
604042951
UBI
WA
Enumeration date
01/22/2018
Last updated
01/22/2018
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