Individual
IBRAHIM MANSHAD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
321 E TITUS ST, KENT, WA 98030-5907
(512) 299-6704
Mailing address
321 E TITUS ST, KENT, WA 98030-5907
(512) 299-6704
Taxonomy
Speciality
Code
Description
License number
State
171R00000X
Interpreter
Primary
604078893-001-0001
WA
Other
Enumeration date
09/01/2020
Last updated
09/01/2020
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