Individual
MANJU LAMA POUDEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5128 YELM HWY SE, LACEY, WA 98503-5038
(360) 763-7040
Mailing address
14121 PARKE LONG CT STE 201, CHANTILLY, VA 20151-1647
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
60760093
WA
363LF0000X
Family Nurse Practitioner
60760093
WA
Other
Enumeration date
08/18/2017
Last updated
05/28/2019
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