Individual ProviderMark Douglas MillerMassage TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address10312 Rainier Ave SW, Lakewood, WA 98499-4759(253) 820-3292PECOS EnrollmentBased on the most recent information from CMS, provider Mark Douglas Miller 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 ID1861640294Provider TypeIndividualFull NameMiller, Mark DouglasTitleMr.CredentialLMPGenderMaleSole ProprietorYesEnumeration Date8/27/2008Last Updated10/25/2021Contact InformationPractice LocationPractice Address10312 Rainier Ave SW, Lakewood, WA 98499-4759Phone(253) 820-3292FaxUnlisted FaxMailing LocationMailing Address10312 Rainier Ave SW, Lakewood, WA 98499-4759Phone(253) 820-3292FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode225700000XPrimaryDescriptionMassage TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicense00022515WashingtonCode172V00000XDescriptionCommunity Health WorkerOther Service ProvidersLicenseMA00022515Washington