Individual
MANFRED SIEGENTHALER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
2031 POTTERY AVE, PORT ORCHARD, WA 98366-2010
(360) 895-6600
Mailing address
2031 POTTERY AVE, PORT ORCHARD, WA 98366-2010
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
P160217766
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P160217766
WASHINGTON STATE DEPT OF HEALTH
WA
Enumeration date
03/09/2013
Last updated
03/09/2013
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