MEDICARE: MICHELLE L COATES LMT

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
1	225700000X	Massage Therapist	17246	OR

General Provider Information

NPI Number	:	1750653481
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELLE L COATES LMT

Provider Business Mailing Address
First Line	:	1161 NW PARK VIEW ST APT 1
Second Line	:
City	:	SEAL ROCK
State	:	OR
Zip	:	97376-9790
Country	:	US
Telephone Number	:	541-961-4897
Fax Number	:

Provider Business Practice Location Address
First Line	:	1161 NW PARK VIEW ST APT 1
Second Line	:
City	:	SEAL ROCK
State	:	OR
Zip	:	97376-9790
Country	:	US
Telephone Number	:	541-961-4897
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/26/2012
Last Update Date	:	03/20/2023

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Directions to “ MICHELLE L COATES LMT” Practice Location

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