BAILEY N. MANTHA-NAGRANT PA-C NPI 1831790591

NPI Information

NPI: 1831790591
Provider Name: BAILEY N. MANTHA-NAGRANT, PA-C
Classification: Physician Assistant - 363AS0400X
Entity Type: Individual

Specialization: Surgical

Organization: PROLIANCE SURGEONS INC PS

PECOS Registration: Yes

Address:
3801 5TH ST SE STE 110
PUYALLUP, WA
ZIP 98374
Phone: (253) 845-9585
Get Directions

Bailey N. Mantha-nagrant, PA-C is a surgical physician assistant in Puyallup, WA with 4 years of experience. Bailey N. Mantha-nagrant, PA-C NPI is 1831790591. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

3801 5TH ST SE STE 110
PUYALLUP, WA
ZIP 98374-106
Phone: (253) 845-9585

The NPI 1831790591 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 11/7/2020 and was last updated on 12/16/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363A00000X	Physician Assistant		PA61101539	WASHINGTON	No
2	363AS0400X	Physician Assistant	Surgical	PA61101539	WASHINGTON	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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