Individual ProviderKelly Dawn AnissipourMassage TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address33440 1st Way S # 8, Federal Way, WA 98003-6222(206) 730-0155PECOS EnrollmentBased on the most recent information from CMS, provider Kelly Dawn Anissipour 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 2 days ago.Profile DetailsProvider ID1023382306Provider TypeIndividualFull NameAnissipour, Kelly DawnTitleMissCredentialLMPGenderFemaleSole ProprietorYesEnumeration Date3/3/2012Last Updated9/28/2021Contact InformationPractice LocationPractice Address33440 1st Way S # 8, Federal Way, WA 98003-6222Phone(206) 730-0155FaxUnlisted FaxMailing LocationMailing AddressPO Box 24924, Federal Way, WA 98093-1924Phone(206) 730-0155FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode225700000XPrimaryDescriptionMassage TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicenseMA00009700Washington