Individual
MS. TINA LOUISE MANTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
24113 72ND AVE E, GRAHAM, WA 98338-7323
(253) 754-8099
Mailing address
24113 72ND AVE E, GRAHAM, WA 98338-7323
(253) 754-8099
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LP00055454
WA
Other
Enumeration date
09/26/2023
Last updated
09/26/2023
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