Individual ProviderRyan Michael WatersMassage TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address1760 Newport Way NW, Issaquah, WA 98027-5354(425) 998-6542(425) 635-8235PECOS EnrollmentBased on the most recent information from CMS, provider Ryan Michael Waters 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 3 days ago.Profile DetailsProvider ID1528570751Provider TypeIndividualFull NameWaters, Ryan MichaelCredentialLMPGenderMaleSole ProprietorYesEnumeration Date10/27/2017Last Updated10/27/2017Contact InformationPractice LocationPractice Address1760 Newport Way NW, Issaquah, WA 98027-5354Phone(425) 998-6542FaxUnlisted FaxMailing LocationMailing Address16446 SE Jones Rd, Renton, WA 98058-8342Phone(425) 635-8235FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode225700000XPrimaryDescriptionMassage TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicenseMA6004149Washington