Individual
MICHAEL BACANI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6225 W MASON RD, DEER PARK, WA 99006-9529
(509) 209-3182
Mailing address
224 N PHILLIPS AVE STE 102, SIOUX FALLS, SD 57104-6062
(800) 478-8223
Taxonomy
Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
Primary
RN00173450
WA
Other
Enumeration date
10/14/2021
Last updated
10/14/2021
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