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Individual

ZACHARIAH MANNING

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
3024 WAYSIDE LOOP, SPRINGFIELD, OR 97477-1331
(541) 746-5352
Mailing address
1755 COBURG RD UNIT 301, EUGENE, OR 97401-4900
(458) 256-0206

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
201709467RN
OR
363L00000X
Nurse Practitioner
Primary
202107861NP-PP
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
202107861NP-PP
OREGON STATE BOARD OF NURSING
OR
Enumeration date
06/12/2018
Last updated
11/18/2021
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