Individual ProviderKenneth De La Torre-RileyMassage TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address1627 S 312th St, Federal Way, WA 98003-4915(253) 839-9330(252) 665-4396PECOS EnrollmentBased on the most recent information from CMS, provider Kenneth De La Torre-Riley 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 ID1942992144Provider TypeIndividualFull NameDe La Torre-Riley, KennethCredentialLMTGenderMaleSole ProprietorYesEnumeration Date5/24/2023Last Updated5/24/2023Contact InformationPractice LocationPractice Address1627 S 312th St, Federal Way, WA 98003-4915Phone(253) 839-9330Fax(253) 839-9330Mailing LocationMailing Address2306 177th St E, Tacoma, WA 98445-4222Phone(252) 665-4396FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode225700000XPrimaryDescriptionMassage TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicenseMA61447554Washington