Provider Demographics
NPI:1205028545
Name:MANLEY, TONIA LYNN (NURSING)
Entity type:Individual
Prefix:
First Name:TONIA
Middle Name:LYNN
Last Name:MANLEY
Suffix:
Gender:F
Credentials:NURSING
Other - Prefix:
Other - First Name:TONIA
Other - Middle Name:LYNN
Other - Last Name:GREEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NURSING
Mailing Address - Street 1:6403 N A ST
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99208-4503
Mailing Address - Country:US
Mailing Address - Phone:253-226-0125
Mailing Address - Fax:
Practice Address - Street 1:1224 W RIVERSIDE AVE APT 107
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99201-1115
Practice Address - Country:US
Practice Address - Phone:509-328-2284
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-10
Last Update Date:2024-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3747A0650X
WARN60176993163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider
No163WH0200XNursing Service ProvidersRegistered NurseHome Health