Individual
KEVIN MANGAT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1000 WALLACE WAY, GRANDVIEW, WA 98930-8805
(509) 788-1702
(509) 786-1022
Mailing address
1000 WALLACE WAY, GRANDVIEW, WA 98930-8805
(510) 396-3348
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
03/29/2024
Last updated
04/04/2024
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