Individual
SVITLANA O KOLTES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPM
Contact information
Practice address
6314 19TH ST.W. SUITE#7, FIRCREST, WA 98466
(253) 988-9717
Mailing address
6314 19TH ST.W., SUITE#7, FIRCREST, WA 98466
(253) 988-9717
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA 00020371
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0199517
DEPARTMENT OF LABOR AND INDUSTRIES
—
Enumeration date
09/23/2008
Last updated
01/04/2011
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