Individual
DEIDRE ANN MANCE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
2120 RYAN RD, BUCKLEY, WA 98321-9115
(360) 829-1111
Mailing address
PO BOX 1377, BUCKLEY, WA 98321-1377
(253) 740-5964
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP61098433
WA
Other
Enumeration date
10/15/2020
Last updated
10/15/2020
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