Individual ProviderKevin Robert VaughanMassage TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address31716 2nd Ave S, Federal Way, WA 98003-5260(253) 880-6462PECOS EnrollmentBased on the most recent information from CMS, provider Kevin Robert Vaughan 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 ID1457626277Provider TypeIndividualFull NameVaughan, Kevin RobertCredentialMA60240947GenderMaleSole ProprietorYesEnumeration Date3/12/2012Last Updated3/12/2012Contact InformationPractice LocationPractice Address31716 2nd Ave S, Federal Way, WA 98003-5260Phone(253) 880-6462FaxUnlisted FaxMailing LocationMailing Address31716 2nd Ave S, Federal Way, WA 98003-5260Phone(253) 880-6462FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode225700000XPrimaryDescriptionMassage TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicenseMA 60240947Washington