Coleman, Raylene Dianne

Coleman, Raylene Dianne is an individual health care provider with primary practice located at 1040 Nw 22Nd Ave Suite 420, Portland OR 97210-3057. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Adult Health, which is considered as her primary health care specialty. Coleman, Raylene Dianne can be contacted via phone (503) 229-7647.

Contact Information

Primary practice address
1040 Nw 22Nd Ave Suite 420 Portland OR 97210-3057
Phone: (503) 229-7647
Fax: (503) 229-7105
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X 080012268N3 Oregon

Profile Details

NPI number 1093717852
LBN Legal business name Coleman, Raylene Dianne
Credentials RN, ANP
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 11th, 2005
Last updated Jul 9th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1093717852 NPPES
Washington MEDICAID 9633942
Washington MEDICAID 268958

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