Organization
DANIEL R. COLEMAN
Active
Other names
Tenino Physical Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL R COLEMAN PT (OWNER)
(360) 264-6622
Entity
Organization
Contact information
Practice address
397 SUSSEX AVE E, TENINO, WA 98589-9272
(360) 264-6622
(360) 264-6624
Mailing address
PO BOX 255, TENINO, WA 98589-0255
(360) 264-6622
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT00002127
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
121283
L&I
WA
05
—
7091473
—
WA
01
—
CO5972
BLUE CROSS
—
01
—
TE5934
REGENCE BLUE SHIELD
WA
Enumeration date
11/02/2007
Last updated
12/03/2010
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