Individual ProviderShannon Rose WillshawMassage TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address10828 Gravelly Lake Dr SW Ste 112, Lakewood, WA 98499-1300(425) 697-0823PECOS EnrollmentBased on the most recent information from CMS, provider Shannon Rose Willshaw 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 ID1215144183Provider TypeIndividualFull NameWillshaw, Shannon RoseCredentialLMPGenderFemaleSole ProprietorYesEnumeration Date5/17/2007Last Updated12/29/2024Contact InformationPractice LocationPractice Address10828 Gravelly Lake Dr SW Ste 112, Lakewood, WA 98499-1300Phone(425) 697-0823FaxUnlisted FaxMailing LocationMailing Address10828 Gravelly Lake Dr SW Ste 112, Lakewood, WA 98499-1300Phone(425) 697-0823FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode225700000XPrimaryDescriptionMassage TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicenseUnlisted IssuerWashingtonCode225700000XDescriptionMassage TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicenseMA00022844Washington