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Individual

GERALD S COLEMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
P.T.

Contact information

Practice address
2302 S UNION AVE, SUITE B-10, TACOMA, WA 98405-1300
(253) 752-9303
(253) 756-7175
Mailing address
2302 S UNION AVE, SUITE B-10, TACOMA, WA 98405-1300
(253) 752-9303
(253) 756-7175

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
PT00000920
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7011869
WA
01
97699
L&I PROVIDER NUMBER
WA
Enumeration date
07/21/2005
Last updated
08/31/2010
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