Individual
MS. COLEEN ERIN SMALL
Active
Individual
MS. COLEEN ERIN SMALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMP
Taxonomy
Speciality
Code
Description
License number
State
172M00000X
Mechanotherapist
Primary
MA00006402
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
424-10
WA LABOR AND INDUSTRIES
WA
01
—
SM5142
REGENCE BLUE SHIELD WA
WA
Enumeration date
05/31/2007
Last updated
07/08/2007
Update your record
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