Individual ProviderClyde O McdadeMassage TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address11008 Gravelly Lake Dr SW, Lakewood, WA 98499-1332(360) 763-9439PECOS EnrollmentBased on the most recent information from CMS, provider Clyde O Mcdade 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 ID1982680815Provider TypeIndividualFull NameMcdade, Clyde OCredentialLMTGenderMaleSole ProprietorNoEnumeration Date12/22/2005Last Updated10/10/2024Contact InformationPractice LocationPractice Address11008 Gravelly Lake Dr SW, Lakewood, WA 98499-1332Phone(360) 763-9439Fax(360) 767-3087Mailing LocationMailing Address11008 Gravelly Lake Dr SW, Lakewood, WA 98499-1332Phone(360) 763-9439Fax(360) 767-3087Provider TaxonomiesCodeDescriptionLicenseCode225700000XPrimaryDescriptionMassage TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicenseMA00010222Washington