Individual ProviderMareesa Shevette GoodwineMassage TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address622 S 320th St Ste B, Federal Way, WA 98003-5263(253) 838-7300PECOS EnrollmentBased on the most recent information from CMS, provider Mareesa Shevette Goodwine 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 2 days ago.Profile DetailsProvider ID1295245975Provider TypeIndividualFull NameGoodwine, Mareesa ShevetteCredentialLMPGenderFemaleSole ProprietorYesEnumeration Date10/6/2017Last Updated10/6/2017Contact InformationPractice LocationPractice Address622 S 320th St Ste B, Federal Way, WA 98003-5263Phone(253) 838-7300Fax(253) 838-0505Mailing LocationMailing Address622 S 320th St Ste B, Federal Way, WA 98003-5263Phone(253) 838-7300Fax(253) 838-0505Provider TaxonomiesCodeDescriptionLicenseCode225700000XPrimaryDescriptionMassage TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicenseMA60769467Washington