MR. NICHOLAS MANKE (NPI# 1164837126) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164837126 |
| Entity Type | Individual |
| Full Name | MR. NICHOLAS MANKE |
| Credential | PA-C |
| Practice Address |
1100 Goethals Dr Richland WA 99352-3300 |
| Mailing Address |
550 Gage Blvd Ste 101 Richland WA 99352-9532 |
| Practice Telephone | 5099464611 |
| Enumeration Date | 2014-06-27 |
| Last Update Date | 2018-03-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PA60820907 | WA | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AM0700X |
Physician Assistant Specialization: Medical |
PA2014-0037 | NM | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1100 Goethals Dr, Richland, WA 993523300 | 5099464611 | |
| 4411 The 25 Way Ne Ste 150, Albuquerque, NM 871095888 | 5053325800 |
| Street Address |
1100 GOETHALS DR |
| City | RICHLAND |
| State | WA |
| Zip Code | 99352-3300 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669474151 | Juan A Cordero Jr. | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1100 Goethals Dr, 3rd Floor, Richland, WA 99352-3304 | 2005-08-15 |
| 1851742415 | Si Feng | Nurse Practitioner | 1100 Goethals Dr, Suite E, Richland, WA 99352-3300 | 2016-06-24 |
| 1801244314 | Christina Durocher | Audiologist | 1100 Goethals Dr, Suite D, Richland, WA 99352-3300 | 2016-05-25 |
| 1548622509 | April Valdez | Nurse Practitioner | 1100 Goethals Dr, Suite F, Richland, WA 99352-3300 | 2016-03-28 |
| 1134587942 | Nathaniel Enoch Boggs | Physician Assistant | 1100 Goethals Dr, Richland, WA 99352-3300 | 2016-02-08 |
| 1831570191 | Timothy Seth Blanscett | Registered Nurse | 1100 Goethals Dr, Ste D, Richland, WA 99352-3300 | 2015-06-12 |
| 1477965929 | Hunter Lee | Physician Assistant | 1100 Goethals Dr, Richland, WA 99352-3300 | 2014-06-02 |
| 1811250764 | Mary Elizabeth Carnaghan | Nurse Practitioner | 1100 Goethals Dr, Suite F, Richland, WA 99352-3300 | 2012-06-15 |
| 1194929273 | Praveen C Korimerla | Internal Medicine | 1100 Goethals Dr, Suite E, Richland, WA 99352-3300 | 2007-06-13 |
| 1144256181 | Iyad Jamali | Internal Medicine | 1100 Goethals Dr, Kadlec Inland Cardiology, Richland, WA 99352-3304 | 2006-06-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326683053 | Thrive On Counseling, LLC | Counselor | 718 Jadwin Avenue, Richland, WA 99352 | 2019-11-18 |
| 1225687650 | Tri-cities Marital and Family Therapy | Marriage & Family Therapist | 925 Stevens Dr., Suite 3a, Richland, WA 99352 | 2019-09-09 |
| 1053966754 | Darla Nicole Carpenter-sams | Social Worker | 845 Stevens Suite 3a, Richland, WA 99352 | 2019-08-08 |
| 1538720735 | Compass Home Health Care | Home Health | 4281 Tigar Lane, Richland, WA 99352 | 2019-06-27 |
| 1164089934 | Tri-city Orthodontics, LLC | Dentist | 3200 Duportail St, Ste 203, Richland, WA 99352 | 2019-05-28 |
| 1760956361 | Behavior Treatment Solutions LLC | Behavioral Analyst | 403 Adams St, Richland, WA 99352 | 2019-01-16 |
| 1528566981 | Rxltc, Pllc | Pharmacy | 969 Stevens Dr Ste 1b, Richland, WA 99352 | 2018-01-31 |
| 1154829992 | Jason Brody Anderson | Registered Nurse | 888 Swift Blvd # 180, Richland, WA 99352 | 2018-01-26 |
| 1093247355 | Anderson Mcgilliard | Physical Therapist | 875 Gage Blvd, Richland, WA 99352 | 2017-03-28 |
| 1871042689 | Jennifer Bramhall | Nurse Practitioner | 1100 Goethals Drive Suite F, Kadlec Inland Cardiology, Richland, WA 99352 | 2016-09-22 |
| Find all providers in zip 99352 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962798991 | Heather M Potter | Physician Assistant | 945 Goethals Dr. Ste 310, Richland, WA 99352 | 2011-06-28 |
| 1467636456 | Billie Jean Knight | Physician Assistant | 943 Stevens Dr., Richland, WA 99352 | 2007-12-26 |
| 1285692285 | Barbara K Mallory | Physician Assistant | 310 Torbett St, Richland, WA 99354-2604 | 2006-05-02 |
| 1356322093 | James Arthur Davidson | Physician Assistant | 1979 Snyder St, Ste 150, Richland, WA 99354-5319 | 2005-11-09 |
| 1336138841 | Jacqueline J Burkes | Physician Assistant | 220 Alston St, Richland, GA 31825-1404 | 2005-10-18 |
| 1629521349 | Matthew John Concienne | Physician Assistant | 888 Swift Blvd, Richland, WA 99352-3514 | 2016-07-29 |
| 1275920597 | Patricia Neuman | Physician Assistant | 1516 Jadwin Ave, Richland, WA 99354-2902 | 2015-04-24 |
| 1285076810 | Elise Sinnwell | Physician Assistant | 310 Torbett St, Richland, WA 99354-2604 | 2013-07-24 |
| 1700222437 | Travis R Henderson | Physician Assistant | 310 Torbett St, Richland, WA 99354-2604 | 2013-05-21 |
| 1518250554 | Timothy Robert Nickolaus | Physician Assistant | 875 Swift Blvd, Richland, WA 99352-3592 | 2011-05-24 |
| Find all providers in RICHLAND | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.