Individual
MICHAEL COFFEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMP, LMT
Contact information
Practice address
9508 NE 70TH ST, VANCOUVER, WA 98662-4536
(503) 380-8211
Mailing address
9508 NE 70TH ST, VANCOUVER, WA 98662-4536
(503) 380-8211
Taxonomy
Speciality
Code
Description
License number
State
172M00000X
Mechanotherapist
Primary
22314
OR
172M00000X
Mechanotherapist
60632491
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
22314
LICENSED MASSAGE THERAPIST
OR
01
—
60632491
LICENSED MASSAGE PRACTITIONER
WA
Enumeration date
07/21/2016
Last updated
07/21/2016
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