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Individual

MIKAYLA MAE MANNIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPN

Contact information

Practice address
6700 MARTIN WAY E STE 117, OLYMPIA, WA 98516-5586
(360) 413-6910
Mailing address
4910 ORVAS CT SE, OLYMPIA, WA 98501-4764
(423) 444-5999

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
89259
TN

Other

Enumeration date
11/25/2025
Last updated
11/25/2025
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