Individual
DR. JOHN W MANNSCHRECK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1254 HIGHLAND AVE, CLARKSTON, WA 99403-2841
(509) 758-6132
(509) 751-9726
Mailing address
1254 HIGHLAND AVE, CLARKSTON, WA 99403-2841
(509) 758-6132
(509) 751-9726
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
M-6236
ID
2085R0202X
Diagnostic Radiology Physician
Primary
MD00026768
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010149194
REGENCE BLUE SHIELD
WA
05
—
1121334
—
WA
01
—
72728
BLUE CROSS OF IDAHO
WA
01
—
P00186232
RAILROAD MEDICARE
WA
Enumeration date
05/12/2006
Last updated
07/25/2024
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