| Susan Coolbaugh, Inc | |
|
6212 75th St W Lakewood WA 98499-8368 | |
| (253) 983-8507 | |
| (253) 983-8576 |
| Full Name | Susan Coolbaugh, Inc |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 6212 75th St W, Lakewood, Washington |
| Authorized Official Name and Position | Susan Frances Coolbaugh (PRESIDENT) |
| Authorized Official Contact | 2539838507 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Susan Coolbaugh, Inc 6212 75th St W Lakewood WA 98499-8368 Ph: (253) 983-8507 | Susan Coolbaugh, Inc 6212 75th St W Lakewood WA 98499-8368 Ph: (253) 983-8507 |
| NPI Number | 1902129620 |
|---|---|
| Provider Enumeration Date | 03/09/2010 |
| Last Update Date | 03/09/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902129620 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | AP30004202 (Washington) | Primary |
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