Individual
CORY W MANLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1906 N 20TH AVE, PASCO, WA 99301-3393
(509) 547-8409
(509) 547-3751
Mailing address
1906 N 20TH AVE, PASCO, WA 99301-3393
(509) 547-8409
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OL1859
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0070315
DEPT OF LABOR & INDUSTRY
WA
05
—
2027712
—
WA
01
—
410049227
RAILROAD MEDICARE
WA
Enumeration date
07/12/2006
Last updated
02/04/2010
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