Healthcare Provider Details

I. General information

NPI: 1285661942
Provider Name (Legal Business Name): PATRICIA ANN COYMAN DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2006
Last Update Date: 11/08/2024
Certification Date: 11/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

508 S 4TH AVE
YAKIMA WA
98902-3547
US

IV. Provider business mailing address

501 S 5TH AVE
YAKIMA WA
98902-3550
US

V. Phone/Fax

Practice location:
  • Phone: 509-574-6139
  • Fax: 509-574-6138
Mailing address:
  • Phone: 509-494-6700
  • Fax: 509-573-6275

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License NumberOP60448684
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License Number44006
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: