Individual ProviderLarry BanningMassage TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address670 NW Gilman Blvd, Issaquah, WA 98027-2444(425) 427-6562(425) 281-1840PECOS EnrollmentBased on the most recent information from CMS, provider Larry Banning 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 4 days ago.Profile DetailsProvider ID1609141878Provider TypeIndividualFull NameBanning, LarryCredentialLMPGenderMaleSole ProprietorNoEnumeration Date3/20/2012Last Updated3/20/2012Contact InformationPractice LocationPractice Address670 NW Gilman Blvd, Issaquah, WA 98027-2444Phone(425) 427-6562FaxUnlisted FaxMailing LocationMailing Address4488 334th Pl SE, Fall City, WA 98024-5800Phone(425) 281-1840FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode225700000XPrimaryDescriptionMassage TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicenseMA60256849Washington