Provider Demographics
NPI:1265636401
Name:COASTAL INTERNAL MEDICINE, PLLC
Entity Type:Organization
Organization Name:COASTAL INTERNAL MEDICINE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:HARRRY
Authorized Official - Last Name:TROEH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:360-538-0135
Mailing Address - Street 1:PO BOX 87
Mailing Address - Street 2:
Mailing Address - City:ABERDEEN
Mailing Address - State:WA
Mailing Address - Zip Code:98520-0022
Mailing Address - Country:US
Mailing Address - Phone:360-538-0135
Mailing Address - Fax:360-533-3475
Practice Address - Street 1:1921 SUMNER AVENUE
Practice Address - Street 2:
Practice Address - City:ABERDEEN
Practice Address - State:WA
Practice Address - Zip Code:98520-2657
Practice Address - Country:US
Practice Address - Phone:360-538-0135
Practice Address - Fax:360-533-3475
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-12
Last Update Date:2007-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty