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NPI Code Detail

MEDICARE: DR. ANDREW PHILIP MANISTA MD

MEDICARE: DR. ANDREW PHILIP MANISTA MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207X00000XOrthopaedic Surgery PhysicianMD60023058WA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MD60023058OTHERWAWASHINGTON STATE

General Provider Information

NPI Number : 1316084056
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ANDREW PHILIP MANISTA MD
Provider Business Mailing Address
First Line : PO BOX 368
Second Line :
City : OLYMPIA
State : WA
Zip : 98507-0368
Country : US
Telephone Number : 360-491-8439
Fax Number : 360-491-6328
Provider Business Practice Location Address
First Line : 3909 9TH AVE SW
Second Line :
City : OLYMPIA
State : WA
Zip : 98502-5134
Country : US
Telephone Number : 360-570-3462
Fax Number : 360-339-7266
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/31/2007
Last Update Date : 06/04/2026

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Directions to “ DR. ANDREW PHILIP MANISTA MD” Practice Location

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