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General NPI Number Information
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NPI Number | 1225375702
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Entity Type | Organization
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Legal Business Name | MICHELE K. COLEMAN DO & ASSOCIATES, INC.
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Dates
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Enumeration Date | 01/03/2013
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Last Update Date | 05/06/2013
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Provider Practice Location Address
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Address Line | 125 N 18TH ST SUITE B
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City | MOUNT VERNON
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State | WA
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Zip | 98273-3902
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Country | US
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Telephone | 360-630-0072
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Fax |
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Provider Business Mailing Address
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Address Line | 414 E WASHINGTON ST
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City | MOUNT VERNON
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State | WA
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Zip | 98274-3935
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Country | US
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Telephone | 360-630-0072
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MICHELE K COLEMAN
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Credential | D.O.
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Telephone | 360-630-0072
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 204D00000X
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Taxonomy Name | Neuromusculoskeletal Medicine & OMM Physician
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License Number | OP60188169
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | OP60188169
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License Number State | WA
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