Individual
DR. AUDREY MANTANONA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
500 LILLY RD NE, OLYMPIA, WA 98506-5195
(360) 477-5101
Mailing address
500 LILLY RD NE, OLYMPIA, WA 98506-5195
(253) 477-5101
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PH.60946512
WA
Other
Enumeration date
11/21/2019
Last updated
08/31/2022
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