Individual
TIERRA MAKENZIE COALMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R-AAC, CPC
Contact information
Practice address
1400 COMMERCE AVE, LONGVIEW, WA 98632-3756
(360) 998-2047
(360) 200-6736
Mailing address
PO BOX 2394, LONGVIEW, WA 98632-8455
(360) 425-8679
(844) 612-6673
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
CG61424610
WA
175T00000X
Peer Specialist
Primary
CG61424610
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2242156
—
WA
Enumeration date
03/27/2023
Last updated
12/12/2024
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