MEDICARE: PISCES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225700000X	Massage Therapist

General Provider Information

NPI Number	:	1538001904
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PISCES LLC

Provider Business Mailing Address
First Line	:	1206 STATE AVE STE H
Second Line	:
City	:	MARYSVILLE
State	:	WA
Zip	:	98270-3645
Country	:	US
Telephone Number	:	626-586-9744
Fax Number	:

Provider Business Practice Location Address
First Line	:	1206 STATE AVE STE H
Second Line	:
City	:	MARYSVILLE
State	:	WA
Zip	:	98270-3645
Country	:	US
Telephone Number	:	626-586-9744
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	LI PAN
Credential	:
Telephone Number	:	626-586-9744

Provider Enumeration Date	:	04/07/2026
Last Update Date	:	04/07/2026

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Directions to “PISCES LLC ” Practice Location

Language	Start Address	Practice Location

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