Healthcare Provider Details

I. General information

NPI: 1962375337
Provider Name (Legal Business Name): CRISTINA ELENA MANEA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CRISTINA ELENA IORGOVEANU

II. Dates (important events)

Enumeration Date: 09/24/2025
Last Update Date: 09/24/2025
Certification Date: 09/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 NE 139TH ST STE 106
VANCOUVER WA
98685-2519
US

IV. Provider business mailing address

5113 NW 137TH CIR
VANCOUVER WA
98685-1620
US

V. Phone/Fax

Practice location:
  • Phone: 360-604-9000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License NumberDENT.DE.70032617
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: