| Dr Manuel Baustista,inc,p.s. | |
|
9115 Bridgeport Way Sw Suite #1 Lakewood WA 98499-2449 | |
| (253) 581-6303 | |
| (253) 581-3316 |
| Full Name | Dr Manuel Baustista,inc,p.s. |
|---|---|
| Speciality | Psychiatry & Neurology - Neurology |
| Location | 9115 Bridgeport Way Sw, Lakewood, Washington |
| Authorized Official Name and Position | Manuel Bautista (PRESIDENT) |
| Authorized Official Contact | 2535816303 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Manuel Baustista,inc,p.s. Po Box 39398 Lakewood WA 98496-3398 Ph: (253) 581-6303 | Dr Manuel Baustista,inc,p.s. 9115 Bridgeport Way Sw Suite #1 Lakewood WA 98499-2449 Ph: (253) 581-6303 |
| NPI Number | 1184883324 |
|---|---|
| Provider Enumeration Date | 06/03/2008 |
| Last Update Date | 06/05/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184883324 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (* (Not Available)) | Primary |
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