Provider Demographics
NPI:1548145873
Name:PONCE-NAVES, MANUELA
Entity type:Individual
Prefix:
First Name:MANUELA
Middle Name:
Last Name:PONCE-NAVES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1540 S PIERCE ST
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80232-7060
Mailing Address - Country:US
Mailing Address - Phone:720-948-9312
Mailing Address - Fax:
Practice Address - Street 1:1880 S PIERCE ST STE 16A
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80232-7143
Practice Address - Country:US
Practice Address - Phone:720-948-9312
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-06
Last Update Date:2025-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COMT.0016400225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist