Provider Demographics
NPI:1487946570
Name:MANION, AMANDA L (PHARMD)
Entity type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:L
Last Name:MANION
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6351 COLUMBIA PIKE
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22041-1224
Mailing Address - Country:US
Mailing Address - Phone:703-256-4598
Mailing Address - Fax:703-256-7654
Practice Address - Street 1:6351 COLUMBIA PIKE
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22041-1224
Practice Address - Country:US
Practice Address - Phone:703-256-4598
Practice Address - Fax:703-256-7654
Is Sole Proprietor?:No
Enumeration Date:2011-05-06
Last Update Date:2011-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202210404183500000X
DCPH100000354183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist