| Mangata Wellness, Inc | |
|
388 State St Ste 704 Salem OR 97301-4023 | |
| (503) 917-9623 | |
| (503) 919-6050 |
| Full Name | Mangata Wellness, Inc |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 388 State St Ste 704, Salem, Oregon |
| Authorized Official Name and Position | Lola White (OWNER) |
| Authorized Official Contact | 5039179623 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mangata Wellness, Inc 388 State St Ste 704 Salem OR 97301-4023 Ph: (503) 917-9623 | Mangata Wellness, Inc 388 State St Ste 704 Salem OR 97301-4023 Ph: (503) 917-9623 |
| NPI Number | 1790419158 |
|---|---|
| Provider Enumeration Date | 07/12/2022 |
| Last Update Date | 07/12/2022 |
| Certification Date | 07/12/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790419158 | NPI | - | NPPES |
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