Individual
SHANALEE H MANZANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1270 KOTNUM ROAD, WARM SPRINGS, OR 97761-1209
(541) 553-1196
(541) 553-2135
Mailing address
PO BOX 1209, WARM SPRINGS, OR 97761-1209
(541) 553-1196
(541) 553-2135
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
5896996-3102
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
273855
—
OR
Enumeration date
10/27/2009
Last updated
10/27/2009
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