Individual
DANIEL RAY COLEMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
397 SUSSEX AVE E, STE A, TENINO, WA 98589-9272
(360) 264-6622
(360) 264-6624
Mailing address
9929 JOHNSON POINT RD NE, OLYMPIA, WA 98516-9339
(360) 438-8042
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT00002127
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
121283
LABOR & INDUSTRIES
WA
05
—
7091473
—
WA
01
—
CO5972
PREMERA BLUE CROSS
WA
01
—
TE5934
REGENCE
WA
Enumeration date
06/02/2006
Last updated
10/09/2007
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