Individual
BEN MANIWATANA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1229 MADISON ST 1440, SEATTLE, WA 98104-3538
(206) 625-0578
(206) 625-9184
Mailing address
1229 MADISON ST 1440, SEATTLE, WA 98104-3538
(206) 625-0578
(206) 625-9184
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
MD60463403
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1467778993
—
WA
Enumeration date
04/08/2010
Last updated
10/16/2015
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