Healthcare Provider Details

I. General information

NPI: 1609673607
Provider Name (Legal Business Name): PATRICK L MCCABE III LMT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/26/2025
Last Update Date: 02/26/2025
Certification Date: 02/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3624 6TH AVE STE B
TACOMA WA
98406-5400
US

IV. Provider business mailing address

1727 N PROSPECT ST
TACOMA WA
98406-8109
US

V. Phone/Fax

Practice location:
  • Phone: 206-877-3288
  • Fax:
Mailing address:
  • Phone: 206-877-3288
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License NumberW56886
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMA60596045
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: