Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Wasana J Phouangmalay, CST, CSFA

Individual provider Surgical Assistant · NPI 1770332413

Wasana J Phouangmalay, CST, CSFA is a Surgical Assistant in Jonesboro, Georgia. Practices as a sole proprietor. Registered with an NPI since 2024.

In the registry since
2024

Practice location Address checks out

137 S Ave
Jonesboro, GA 30236-4948
Phone: (404) 435-3216
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgical Assistant (primary) Taxonomy 246ZC0007X

Record details

NPI number1770332413
Entity typeIndividual (Type 1)
GenderFemale
Credentials CST , CSFA
Sole proprietorYes
NPI enumeratedMay 15, 2024
Last updated in NPPESMay 15, 2024
Certification dateMay 15, 2024

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