Individual
DR. ROGER RYAN COLEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
1344 E MAIN STREET, OTHELLO, WA 99344-1559
(509) 488-9679
(509) 488-9670
Mailing address
PO BOX 564, OTHELLO, WA 99344-0564
(509) 488-9679
(509) 488-9670
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
300
WY
111N00000X
Chiropractor
Primary
CH00001013
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14322
DEPT OF L & I
WA
05
—
2212306
—
WA
Enumeration date
11/16/2006
Last updated
07/08/2007
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