Individual ProviderShonelle Uilani Pascua GongobMassage TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address7308 Bridgeport Way W, Ste. 103, Lakewood, WA 98499-8000(253) 582-8142(253) 564-1560PECOS EnrollmentBased on the most recent information from CMS, provider Shonelle Uilani Pascua Gongob 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 ID1245588490Provider TypeIndividualFull NameGongob, Shonelle Uilani PascuaCredentialLMPGenderFemaleSole ProprietorNoEnumeration Date8/20/2012Last Updated8/20/2012Contact InformationPractice LocationPractice Address7308 Bridgeport Way W, Ste. 103, Lakewood, WA 98499-8000Phone(253) 582-8142Fax(253) 582-8160Mailing LocationMailing Address4040 Orchard St W, Ste. 100, Fircrest, WA 98466-6606Phone(253) 564-1560Fax(253) 564-4449Provider TaxonomiesCodeDescriptionLicenseCode225700000XPrimaryDescriptionMassage TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicenseMA60290683Washington