Provider Demographics
NPI:1730709924
Name:MANN, VALERIE MARIE
Entity type:Individual
Prefix:MRS
First Name:VALERIE
Middle Name:MARIE
Last Name:MANN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5811 SADDLE CREEK LN
Mailing Address - Street 2:
Mailing Address - City:PASCO
Mailing Address - State:WA
Mailing Address - Zip Code:99301-8006
Mailing Address - Country:US
Mailing Address - Phone:509-554-0900
Mailing Address - Fax:
Practice Address - Street 1:5811 SADDLE CREEK LN
Practice Address - Street 2:
Practice Address - City:PASCO
Practice Address - State:WA
Practice Address - Zip Code:99301-8006
Practice Address - Country:US
Practice Address - Phone:509-554-0900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-17
Last Update Date:2020-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA1163792085U0001X
WA332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No2085U0001XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Ultrasound