Individual
MICHAEL MATTHEW COFFEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.D.
Contact information
Practice address
616 E FRONT ST, PORT ANGELES, WA 98362-3320
(360) 457-6131
(360) 457-6215
Mailing address
616 E FRONT ST, PORT ANGELES, WA 98362-3320
(360) 457-6131
(360) 457-6215
Taxonomy
Speciality
Code
Description
License number
State
122400000X
Denturist
Primary
DN00000399
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5048269
—
WA
Enumeration date
01/22/2007
Last updated
07/08/2007
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