Organization
TRAVELING PAIN MANAGEMENT DOCTORS PSC
Active
Other names
Crown Health 'Traveling Doctors'
Organization subpart
No
Provider details
NPI number
Authorized official
TRACI M MANCUSO ARNP (FAMILY NURSE PRACTITIONER)
(509) 389-6945
Entity
Organization
Contact information
Practice address
21234 SE 273RD PL, MAPLE VALLEY, WA 98038-3350
(509) 389-6945
Mailing address
21234 SE 273RD PL, MAPLE VALLEY, WA 98038-3350
(509) 389-6945
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP30006855
WA
Other
Enumeration date
03/14/2013
Last updated
02/21/2014
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