Individual
DR. ANDREW PHILIP MANISTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
404 YAUGER WAY SW, SUITE 100, OLYMPIA, WA 98502-8660
(360) 786-8990
(360) 786-9010
Mailing address
PO BOX 368, OLYMPIA, WA 98507-0368
(360) 491-8439
(360) 491-6328
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
MD60023058
WA
207X00000X
Orthopaedic Surgery Physician
P17178
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8521981
—
WA
01
—
MD60023058
WASHINGTON STATE
WA
Enumeration date
01/31/2007
Last updated
10/02/2008
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