Individual ProviderAndre Augustus ChiesaBehavior TechnicianBehavioral Health & Social Service ProvidersPractice Address4100 194th St SW Ste 100, Lynnwood, WA 98036-4613(425) 426-2761PECOS EnrollmentBased on the most recent information from CMS, provider Andre Augustus Chiesa 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 12:57 PM.Profile DetailsProvider ID1538652458Provider TypeIndividualFull NameChiesa, Andre AugustusGenderMaleSole ProprietorNoEnumeration Date6/14/2018Last Updated6/14/2018Contact InformationPractice LocationPractice Address4100 194th St SW Ste 100, Lynnwood, WA 98036-4613Phone(425) 426-2761FaxUnlisted FaxMailing LocationMailing Address21600 Oxnard St Ste 1800, Woodland Hills, CA 91367-7807PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode106S00000XPrimaryDescriptionBehavior TechnicianBehavioral Health & Social Service ProvidersLicenseUnlisted IssuerWashington