Individual
GWYN M. MANNERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
325 9TH AVE, BOX 359798, SEATTLE, WA 98104-2420
(206) 697-1162
(206) 744-3830
Mailing address
325 9TH AVE, BOX 359750, SEATTLE, WA 98104-2420
(206) 697-1162
(206) 744-3830
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
AP30006701
WA
363LF0000X
Family Nurse Practitioner
Primary
AP30006701
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0217077
L&I PIN
WA
01
—
25793U
REGENCE PIN
WA
05
—
9640871
—
WA
Enumeration date
12/20/2006
Last updated
09/22/2009
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