Individual
DR. TED COLEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
11102 SUNRISE BLVD E, SUITE 103, PUYALLUP, WA 98374
(253) 848-8797
(253) 845-0100
Mailing address
11102 SUNRISE BLVD E,, SUITE 103, PUYALLUP, WA 98374
(253) 848-8797
(253) 845-0100
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
4301046463
MI
207P00000X
Emergency Medicine Physician
Primary
MD60597143
WA
207Q00000X
Family Medicine Physician
MD60597143
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11273896
CAQH
—
05
—
1285612879
—
WA
Enumeration date
01/04/2006
Last updated
01/13/2016
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