Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QG0300X | Family Doctor - Geriatric Medicine | 44006 | CO |
NPI | 1285661942 |
---|---|
Provider Name | Patricia Ann Coyman |
First Address | Yakima, WA 98902-3550 |
Second Address | Yakima, WA 98902-3547 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/06/2006 |
Last Update Date | 15/05/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H45766 | (02) | AZ |