Healthcare Provider Details

I. General information

NPI: 1083527246
Provider Name (Legal Business Name): MANNA AMARE RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3410 S 203RD ST
SEATAC WA
98198-5754
US

IV. Provider business mailing address

3410 S 203RD ST
SEATAC WA
98198-5754
US

V. Phone/Fax

Practice location:
  • Phone: 206-307-4845
  • Fax:
Mailing address:
  • Phone: 206-307-4845
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN300723
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: