Individual
RAJESH MANAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1703 S MERIDIAN STE 305, PUYALLUP, WA 98371-7590
(253) 272-8512
Mailing address
1703 S MERIDIAN STE 305, PUYALLUP, WA 98371-7590
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
MD00047698
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8483893
—
WA
01
—
MD00047698
WA LICENSE
WA
Enumeration date
05/29/2007
Last updated
06/21/2019
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