Healthcare Provider Details
I. General information
NPI: 1801837885
Provider Name (Legal Business Name): MANCONG ZHANG MD, PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/09/2006
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
13103 E MANSFIELD AVE
SPOKANE VALLEY WA
99216-1642
US
IV. Provider business mailing address
PO BOX 3405
SPOKANE WA
99220-3405
US
V. Phone/Fax
- Phone: 509-892-2700
- Fax: 509-892-2740
- Phone: 509-892-2700
- Fax: 509-342-2743
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207ZP0102X |
| Taxonomy | Anatomic Pathology & Clinical Pathology Physician |
| License Number | MD00043482 |
| License Number State | WA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207ZD0900X |
| Taxonomy | Dermatopathology (Pathology) Physician |
| License Number | M-9091 |
| License Number State | ID |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207ZD0900X |
| Taxonomy | Dermatopathology (Pathology) Physician |
| License Number | MED-PHYS-LIC-11006 |
| License Number State | MT |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207ZP0102X |
| Taxonomy | Anatomic Pathology & Clinical Pathology Physician |
| License Number | 102822 |
| License Number State | AK |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207ZP0102X |
| Taxonomy | Anatomic Pathology & Clinical Pathology Physician |
| License Number | 53719 |
| License Number State | AZ |
| # 6 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207ZD0900X |
| Taxonomy | Dermatopathology (Pathology) Physician |
| License Number | 53719 |
| License Number State | AZ |
| # 7 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207ZD0900X |
| Taxonomy | Dermatopathology (Pathology) Physician |
| License Number | MD186902 |
| License Number State | OR |
| # 8 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207ZD0900X |
| Taxonomy | Dermatopathology (Pathology) Physician |
| License Number | 102822 |
| License Number State | AK |
| # 9 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207ZD0900X |
| Taxonomy | Dermatopathology (Pathology) Physician |
| License Number | MD00043482 |
| License Number State | WA |
| # 10 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207ZP0102X |
| Taxonomy | Anatomic Pathology & Clinical Pathology Physician |
| License Number | M-9091 |
| License Number State | ID |
| # 11 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207ZP0102X |
| Taxonomy | Anatomic Pathology & Clinical Pathology Physician |
| License Number | MD186902 |
| License Number State | OR |
| # 12 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207ZP0102X |
| Taxonomy | Anatomic Pathology & Clinical Pathology Physician |
| License Number | MED-PHYS-LIC-11006 |
| License Number State | MT |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: