Individual ProviderAndrew C HetzerMassage TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address8909 Gravelly Lake Dr SW, Lakewood, WA 98499-3101(253) 584-1144PECOS EnrollmentBased on the most recent information from CMS, provider Andrew C Hetzer 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 ID1124326350Provider TypeIndividualFull NameHetzer, Andrew CCredentialLMPGenderMaleSole ProprietorNoEnumeration Date3/11/2011Last Updated3/11/2011Contact InformationPractice LocationPractice Address8909 Gravelly Lake Dr SW, Lakewood, WA 98499-3101Phone(253) 584-1144FaxUnlisted FaxMailing LocationMailing Address5338 Beverly Dr NE, Olympia, WA 98516-2218PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode225700000XPrimaryDescriptionMassage TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicenseMA 60072934Washington