Individual ProviderMiranda Rose GoodroadMassage TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address8615 S Tacoma Way, Lakewood, WA 98499-4542(253) 588-3355PECOS EnrollmentBased on the most recent information from CMS, provider Miranda Rose Goodroad 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 10:51 AM.Profile DetailsProvider ID1821490764Provider TypeIndividualFull NameGoodroad, Miranda RoseCredentialLMPGenderFemaleSole ProprietorNoEnumeration Date9/23/2014Last Updated9/23/2014Contact InformationPractice LocationPractice Address8615 S Tacoma Way, Lakewood, WA 98499-4542Phone(253) 588-3355FaxUnlisted FaxMailing LocationMailing Address8615 S Tacoma Way, Lakewood, WA 98499-4542Phone(253) 588-3355FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode225700000XPrimaryDescriptionMassage TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicenseMA 00025034Washington