Individual
MR. NICHOLAS MANKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1100 GOETHALS DR, RICHLAND, WA 99352-3300
(509) 946-4611
Mailing address
550 GAGE BLVD STE 101, RICHLAND, WA 99352-9532
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
PA2014-0037
NM
363AM0700X
Medical Physician Assistant
Primary
PA60820907
WA
Other
Enumeration date
06/27/2014
Last updated
03/17/2018
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