# AT FAMILY PRACTICE GROUP PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1346938685
- **Authorized official:** AMANDEEP MANN (PROVIDER)
- **Authorized official phone:** (253) 394-6574

## Contact information

- **Practice address:** 24604 104TH AVE SE STE 201, KENT, WA 98030-5385
- **Practice address phone:** (253) 854-9799
- **Practice address fax:** (253) 854-9801
- **Mailing address:** 24604 104TH AVE SE STE 201, KENT, WA 98030-5385
- **Mailing address phone:** (253) 854-9799
- **Mailing address fax:** (253) 854-9801

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 04/25/2023
- **Last updated:** 10/15/2026