MEDICARE: PATRICK L MCCABE III LMT

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	171400000X	Health & Wellness Coach	W56886	WA
2	225700000X	Massage Therapist	MA60596045	WA

General Provider Information

NPI Number	:	1609673607
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATRICK L MCCABE III LMT

Provider Business Mailing Address
First Line	:	1727 N PROSPECT ST
Second Line	:
City	:	TACOMA
State	:	WA
Zip	:	98406-8109
Country	:	US
Telephone Number	:	206-877-3288
Fax Number	:

Provider Business Practice Location Address
First Line	:	3624 6TH AVE STE B
Second Line	:
City	:	TACOMA
State	:	WA
Zip	:	98406-5400
Country	:	US
Telephone Number	:	206-877-3288
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/26/2025
Last Update Date	:	02/26/2025

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