# COASTAL INTERNAL MEDICINE, PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1740528884
- **Authorized official:** MICHELLE PELT (CLINIC ADMINISTRATOR)
- **Authorized official phone:** (360) 538-0135

## Contact information

- **Practice address:** 1921 SUMNER AVE, ABERDEEN, WA 98520-3606
- **Practice address phone:** (360) 538-0135
- **Practice address fax:** (360) 533-3475
- **Mailing address:** PO BOX 87, ABERDEEN, WA 98520-0022
- **Mailing address phone:** (360) 538-0135
- **Mailing address fax:** (360) 533-3475

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363A00000X | Physician Assistant | PA60328816 | WA | Yes |

## Other

- **Enumeration date:** 01/24/2013
- **Last updated:** 01/24/2013