Individual
MR. MICHAEL C. MANDZIARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
9631 N NEVADA ST STE 300, SPOKANE, WA 99218-1193
(509) 465-3919
(509) 227-7070
Mailing address
PO BOX 421, LIBERTY LAKE, WA 99019-0421
(866) 747-2455
(509) 227-7070
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
5601007182
MI
363A00000X
Physician Assistant
Primary
PA61256932
WA
Other
Enumeration date
09/23/2014
Last updated
03/21/2024
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