Roger Ryan Coleman, DC
Individual provider Active NPI Chiropractor · Othello, WA
NPI 1689747883 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1689747883
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- CH00001013 (WA)
- Practice address
- 1344 E Main Street
Othello, WA 99344-1559 - Phone
- (509) 488-9679
- Fax
- (509) 488-9670
- NPI assigned
- Nov 16, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 300 | WY | MD | Occupational Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | CH00001013 | WA | Yes |
| Chiropractor | 111N00000X | 300 | WY |
Addresses
Primary practice location
1344 E Main Street
Othello, WA 99344-1559
Mailing address
PO Box 564
Othello, WA 99344-0564
Phone (509) 488-9679
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2212306 | Medicaid | WA | |
| 14322 | Other | WA | DEPT OF L & I |
Other providers in Othello, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.