Healthcare Provider Details

I. General information

NPI: 1962821991
Provider Name (Legal Business Name): BERTHINA B. COLEMAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/07/2014
Last Update Date: 03/17/2025
Certification Date: 03/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

747 BROADWAY, SUITE WW- 739 SWEDISH MEDICAL CENTER, GENERAL SURGERY RESIDENCY PROGR
SEATTLE WA
98122-4307
US

IV. Provider business mailing address

PO BOX 50095
SEATTLE WA
98145-5095
US

V. Phone/Fax

Practice location:
  • Phone: 206-386-2123
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number0101282152
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number229231
License Number StateAK
# 3
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberMD60881108
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: