Individual ProviderCharles William O'BrienMassage TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address9840 Dekoven Dr. SW, Lakewood, WA 98499-1825(253) 886-0746PECOS EnrollmentBased on the most recent information from CMS, provider Charles William O'Brien 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 ID1881048916Provider TypeIndividualFull NameO'Brien, Charles WilliamTitleMr.CredentialC.R. L.M.P.GenderMaleSole ProprietorYesEnumeration Date4/14/2016Last Updated4/14/2016Contact InformationPractice LocationPractice Address9840 Dekoven Dr. SW, Lakewood, WA 98499-1825Phone(253) 886-0746FaxUnlisted FaxMailing LocationMailing Address9840 Dekoven Dr. SW, Lakewood, WA 98499-1825Phone(253) 886-0746FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode225700000XPrimaryDescriptionMassage TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicenseMA60466209Washington