Individual ProviderNicole Arlene LopezMassage TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address710 5th Ave NW Ste 300, Issaquah, WA 98027-2845(425) 998-6542(248) 436-4400PECOS EnrollmentBased on the most recent information from CMS, provider Nicole Arlene Lopez does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 10:05 AM.Profile DetailsProvider ID1003419870Provider TypeIndividualFull NameLopez, Nicole ArleneCredentialLMTGenderFemaleSole ProprietorNoEnumeration Date11/16/2020Last Updated4/25/2023Contact InformationPractice LocationPractice Address710 5th Ave NW Ste 300, Issaquah, WA 98027-2845Phone(425) 998-6542FaxUnlisted FaxMailing LocationMailing Address27777 Inkster Rd Ste 100, Farmington Hills, MI 48334-5312Phone(248) 436-4400FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode225700000XPrimaryDescriptionMassage TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicenseMA61380495Washington