Organization
CLOVER PODIATRY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TEK MANNING FISH DPM (SURGEON/OWNER)
(360) 450-6644
Entity
Organization
Contact information
Practice address
405 NE 6TH AVE, CAMAS, WA 98607-2037
(360) 450-6644
(360) 524-7847
Mailing address
405 NE 6TH AVE, CAMAS, WA 98607-2037
(360) 450-6644
(360) 524-7847
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2169432
—
WA
Enumeration date
07/13/2020
Last updated
01/22/2021
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