Individual ProviderSamantha GobleMassage TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address8909 Gravelly Lake Dr SW Ste B, Lakewood, WA 98499-3101(253) 584-1144(253) 886-1459PECOS EnrollmentBased on the most recent information from CMS, provider Samantha Goble 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 ID1124835996Provider TypeIndividualFull NameGoble, SamanthaCredentialLMTGenderFemaleSole ProprietorNoEnumeration Date12/16/2024Last Updated12/16/2024Contact InformationPractice LocationPractice Address8909 Gravelly Lake Dr SW Ste B, Lakewood, WA 98499-3101Phone(253) 584-1144FaxUnlisted FaxMailing LocationMailing Address2315 Westridge Ave W Apt B13, Tacoma, WA 98466-8207Phone(253) 886-1459FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode225700000XPrimaryDescriptionMassage TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicenseMT134310Texas