Individual ProviderMichael Stephen AngeloMassage TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address6002 Mount Tacoma Dr SW Ste B, Lakewood, WA 98499-2703(253) 475-7466(252) 665-1669PECOS EnrollmentBased on the most recent information from CMS, provider Michael Stephen Angelo 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 10:51 AM.Profile DetailsProvider ID1013772037Provider TypeIndividualFull NameAngelo, Michael StephenCredentialLMTGenderMaleSole ProprietorNoEnumeration Date2/19/2024Last Updated2/19/2024Contact InformationPractice LocationPractice Address6002 Mount Tacoma Dr SW Ste B, Lakewood, WA 98499-2703Phone(253) 475-7466FaxUnlisted FaxMailing LocationMailing Address4444 6th Ave SE Apt 342, Lacey, WA 98503-1086Phone(252) 665-1669FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode225700000XPrimaryDescriptionMassage TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicenseMA61513169Washington