IndividualActive
Mansuru Mustapha, PHYSICIAN ASSISTANT
NPI 1013159193 · Physician Assistant · Jblm, WA
Provider details
- NPI number
- 1013159193
- Entity type
- Individual
- Primary specialty
- Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- PHYSICIAN ASSISTANT
- Sex
- Male
- Sole proprietor
- No
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Practice location
9119 Mil Park Ave
Winder Clinic -Raider Clinic
Jblm, WA 98433-1100
Phone: (253) 477-0800
Approximate (ZIP-level) locationGet directions
Mailing address
Madigan Army Center 9040 Reid St
Tacoma, WA 98431-1100
Registry dates
- Enumerated
- 2009-04-03
- Last updated
- 2013-05-30
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.