Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | 05259 | OR |
NPI | 1003929605 |
---|---|
Provider Name | Shelia Helene Coe |
First Address | Walla Walla, WA 99362-7773 |
Second Address | Pendleton, OR 97801 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/08/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
171037 | (05) | OR |