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General NPI Number Information
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NPI Number | 1831306224
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Entity Type | Organization
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Legal Business Name | MANALOTO AND RACSA MD PS
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Dates
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Enumeration Date | 05/17/2007
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Last Update Date | 08/31/2010
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Provider Practice Location Address
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Address Line | 527 W PARK ST SUITE 3
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City | PASCO
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State | WA
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Zip | 99301-5265
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Country | US
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Telephone | 509-547-0503
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Fax | 509-547-5815
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Provider Business Mailing Address
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Address Line | 527 W PARK ST SUITE 3
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City | PASCO
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State | WA
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Zip | 99301-5265
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Country | US
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Telephone | 509-547-0503
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Fax | 509-547-5815
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Authorized Official
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Title or Position | DOCTOR
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Name | DR. GERTRUDES B MANALOTO-RACSA
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Credential | MD
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Telephone | 509-547-0503
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | MD00014929
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MD00016945
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License Number State | WA
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