Individual
ANTONETTE MANIGSACA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
605 WOODLAND SQUARE LOOP SE, LACEY, WA 98503-1045
(360) 764-8400
Mailing address
605 WOODLAND SQUARE LOOP SE, LACEY, WA 98503-1045
(360) 764-8400
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
AP61616863
WA
Other
Enumeration date
06/25/2024
Last updated
10/29/2024
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