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NPI Code Detail

MEDICARE: CAYLEE MICHELLE COULTER

MEDICARE: CAYLEE MICHELLE COULTER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225700000XMassage TherapistMA60802502WA

General Provider Information

NPI Number : 1437666286
Entity Type Code : Individual
Provider Name (Legal Business Name) : CAYLEE MICHELLE COULTER
Provider Business Mailing Address
First Line : 1800 SE MILE HILL DR STE 150
Second Line :
City : PORT ORCHARD
State : WA
Zip : 98366-3517
Country : US
Telephone Number : 406-544-5194
Fax Number :
Provider Business Practice Location Address
First Line : 1800 SE MILE HILL DR STE 150
Second Line :
City : PORT ORCHARD
State : WA
Zip : 98366-3517
Country : US
Telephone Number : 406-544-5194
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/02/2018
Last Update Date : 01/02/2018

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Directions to “ CAYLEE MICHELLE COULTER ” Practice Location

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