Individual ProviderAlexandrea PetersonMassage TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address8615 S Tacoma Way, Lakewood, WA 98499-4542(253) 588-3355PECOS EnrollmentBased on the most recent information from CMS, provider Alexandrea Peterson 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 ID1255756078Provider TypeIndividualFull NamePeterson, AlexandreaCredentialLMPGenderFemaleSole ProprietorYesEnumeration Date3/3/2014Last Updated3/3/2014Contact InformationPractice LocationPractice Address8615 S Tacoma Way, Lakewood, WA 98499-4542Phone(253) 588-3355Fax(253) 588-3367Mailing LocationMailing Address8615 S Tacoma Way, Lakewood, WA 98499-4542Phone(253) 588-3355Fax(253) 588-3367Provider TaxonomiesCodeDescriptionLicenseCode225700000XPrimaryDescriptionMassage TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicenseMA60336508Washington