Provider Demographics
NPI:1790503852
Name:LALANGAN, MANOLITO
Entity type:Individual
Prefix:
First Name:MANOLITO
Middle Name:
Last Name:LALANGAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1201 132ND ST S
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98444-7100
Mailing Address - Country:US
Mailing Address - Phone:210-722-5073
Mailing Address - Fax:253-625-7971
Practice Address - Street 1:1201 132ND ST S
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98444-7100
Practice Address - Country:US
Practice Address - Phone:210-722-5073
Practice Address - Fax:253-625-7971
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-27
Last Update Date:2024-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA756999311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home