Provider Demographics
NPI:1558548172
Name:COON, BARBARA JEAN (LMP)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:JEAN
Last Name:COON
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12036 PHINNEY AVE N
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98133-8134
Mailing Address - Country:US
Mailing Address - Phone:206-368-8730
Mailing Address - Fax:206-368-8730
Practice Address - Street 1:5505 30TH AVE NE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98105-5501
Practice Address - Country:US
Practice Address - Phone:206-391-4222
Practice Address - Fax:206-368-8730
Is Sole Proprietor?:No
Enumeration Date:2008-01-25
Last Update Date:2008-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00006818174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist