Individual
MIHAIL MADAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
22106 43RD AVE W, MOUNTLAKE TERRACE, WA 98043-3611
(206) 430-3889
Mailing address
22106 43RD AVE W, MOUNTLAKE TERRACE, WA 98043-3611
(206) 430-3889
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
A755204
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2195411
—
WA
Enumeration date
05/05/2022
Last updated
05/05/2022
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