Individual
KIA NICOLE PANGELINAN-MANAHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CO61397454
Contact information
Practice address
1601 E FOURTH PLAIN BLVD BLDG 17, VANCOUVER, WA 98661-3717
(360) 558-5795
Mailing address
5209 NE 34TH ST APT A2, VANCOUVER, WA 98661-6496
(360) 787-5272
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CO61397454
WA
Other
Enumeration date
04/27/2023
Last updated
05/15/2023
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