Individual ProviderTheresa Ann StoppardMassage TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address485 Mount Defiance Cir SW, Issaquah, WA 98027-3630(425) 495-6940PECOS EnrollmentBased on the most recent information from CMS, provider Theresa Ann Stoppard 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 ID1942566955Provider TypeIndividualFull NameStoppard, Theresa AnnCredentialLMPGenderFemaleSole ProprietorNoEnumeration Date4/3/2012Last Updated4/3/2012Contact InformationPractice LocationPractice Address485 Mount Defiance Cir SW, Issaquah, WA 98027-3630Phone(425) 495-6940FaxUnlisted FaxMailing LocationMailing Address485 Mount Defiance Cir SW, Issaquah, WA 98027-3630PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode225700000XPrimaryDescriptionMassage TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicenseMA60270866Washington