Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2251G0304X | Physical Therapist - Geriatrics | 1610 | OR |
Y | 2251G0304X | Physical Therapist - Geriatrics | PT00006403 | WA |
NPI | 1114033487 |
---|---|
Provider Name | Nancy Marie Mcmanus |
First Address | Vancouver, WA 98682 |
Second Address | Vancouver, WA 98682-4933 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/08/2006 |
Last Update Date | 30/12/2021 |