Provider Demographics
NPI:1649606328
Name:MANN, HILARY KATHLEEN (LMP)
Entity type:Individual
Prefix:MS
First Name:HILARY
Middle Name:KATHLEEN
Last Name:MANN
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:304 GRANT ROAD
Mailing Address - Street 2:SUITE #1
Mailing Address - City:EAST WENATCHEE
Mailing Address - State:WA
Mailing Address - Zip Code:98802
Mailing Address - Country:US
Mailing Address - Phone:509-884-4200
Mailing Address - Fax:509-884-4201
Practice Address - Street 1:304 GRANT ROAD
Practice Address - Street 2:SUITE #1
Practice Address - City:EAST WENATCHEE
Practice Address - State:WA
Practice Address - Zip Code:98802
Practice Address - Country:US
Practice Address - Phone:509-884-4200
Practice Address - Fax:509-884-4201
Is Sole Proprietor?:No
Enumeration Date:2013-09-25
Last Update Date:2013-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60390326225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist