Individual ProviderAntwan EaffordMassage TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address728 S 320th St Ste G, Federal Way, WA 98003-5255(205) 212-6352(253) 278-4275PECOS EnrollmentBased on the most recent information from CMS, provider Antwan Eafford 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 ID1104316124Provider TypeIndividualFull NameEafford, AntwanTitleMr.CredentialLMTGenderMaleSole ProprietorYesEnumeration Date5/15/2018Last Updated10/25/2023Contact InformationPractice LocationPractice Address728 S 320th St Ste G, Federal Way, WA 98003-5255Phone(205) 212-6352FaxUnlisted FaxMailing LocationMailing AddressPO Box 5832, Kent, WA 98064-5832Phone(253) 278-4275FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode225700000XPrimaryDescriptionMassage TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicenseMA60854335WashingtonCode225700000XDescriptionMassage TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicenseUnlisted IssuerWashington