Individual
MANSOUR V SHIRBACHEH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1708 YAKIMA AVE, STE 115, TACOMA, WA 98405-5307
(253) 682-0925
(253) 682-0927
Mailing address
1708 YAKIMA AVE STE 104, TACOMA, WA 98405-5307
(253) 591-6739
(253) 426-6344
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
MD00041506
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1045856
—
WA
Enumeration date
01/23/2007
Last updated
12/09/2020
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