IndividualActive
Kenneth Mandler, C.O. CERTIFIED ORTHO
NPI 1154470193 · Orthotist · Liberty Lake, WA
Provider details
- NPI number
- 1154470193
- Entity type
- Individual
- Primary specialty
- OrthotistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Credential
- C.O. CERTIFIED ORTHO
- Sex
- Male
- Sole proprietor
- Yes
- License
- DI00000466 (WA)
Practice location
509 N Homestead Dr
Liberty Lake, WA 99019-7580
Phone: (509) 389-4783
Mailing address
509 N Homestead Dr
Liberty Lake, WA 99019-7580
Registry dates
- Enumerated
- 2007-01-09
- Last updated
- 2023-10-18
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.