Provider Demographics
NPI:1083894737
Name:MANAGHAN, KARLA LOUISE (RDH, LMP)
Entity Type:Individual
Prefix:MRS
First Name:KARLA
Middle Name:LOUISE
Last Name:MANAGHAN
Suffix:
Gender:F
Credentials:RDH, LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8911 E EUCLID AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99212-2048
Mailing Address - Country:US
Mailing Address - Phone:509-216-1700
Mailing Address - Fax:509-534-1959
Practice Address - Street 1:5218 N MULVANEY CT
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99212-1611
Practice Address - Country:US
Practice Address - Phone:509-216-1700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-10
Last Update Date:2007-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00023691174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist