Individual ProviderAmanda Marie WillertMassage TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address1760 Newport Way NW, Issaquah, WA 98027-5354(425) 998-6542(612) 220-0806PECOS EnrollmentBased on the most recent information from CMS, provider Amanda Marie Willert 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 ID1770077265Provider TypeIndividualFull NameWillert, Amanda MarieCredentialLMTGenderFemaleSole ProprietorNoEnumeration Date6/18/2018Last Updated6/18/2018Contact InformationPractice LocationPractice Address1760 Newport Way NW, Issaquah, WA 98027-5354Phone(425) 998-6542FaxUnlisted FaxMailing LocationMailing Address4425 Issaquah Pine Lake Rd SE Apt Q6, Sammamish, WA 98075-6221Phone(612) 220-0806FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode225700000XPrimaryDescriptionMassage TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicenseMA60867966Washington