Individual ProviderAmber Elise LarsonMassage TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address32030 23rd Ave S, Federal Way, WA 98003-6031(253) 946-4852(253) 630-6768PECOS EnrollmentBased on the most recent information from CMS, provider Amber Elise Larson 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 ID1790082733Provider TypeIndividualFull NameLarson, Amber EliseCredentialLMPGenderFemaleSole ProprietorYesEnumeration Date2/25/2011Last Updated2/5/2019Contact InformationPractice LocationPractice Address32030 23rd Ave S, Federal Way, WA 98003-6031Phone(253) 946-4852FaxUnlisted FaxMailing LocationMailing Address790 Remington Blvd, Bolingbrook, IL 60440 (United States Minor Outlying Islands)Phone(253) 630-6768Fax(253) 630-6639Provider TaxonomiesCodeDescriptionLicenseCode225700000XPrimaryDescriptionMassage TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicenseMA60160203Washington