Individual
CHITRA MANICKAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
20200 54TH AVE W, LYNNWOOD, WA 98036-6318
(425) 672-6400
Mailing address
20200 54TH AVE W, LYNNWOOD, WA 98036-6318
(425) 672-6400
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD60330571
WA
207RR0500X
Rheumatology Physician
Primary
35.098192
OH
Other
Enumeration date
07/12/2011
Last updated
04/27/2021
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