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General NPI Number Information
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NPI Number | 1205113453
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Entity Type | Individual
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Provider Name | MICHELLE MANAOIS RPH
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Gender | Female
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Dates
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Enumeration Date | 11/15/2011
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Last Update Date | 11/15/2011
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Provider Practice Location Address
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Address Line | 12400 E MARGINAL WAY S
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City | TUKWILA
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State | WA
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Zip | 98168-2559
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Country | US
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Telephone | 206-901-4450
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Fax |
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Provider Business Mailing Address
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Address Line | 3022 S MOUNT BAKER BLVD
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City | SEATTLE
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State | WA
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Zip | 98144-6140
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Country | US
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Telephone | 206-427-3087
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PH60205789
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License Number State | WA
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