Provider Demographics
NPI:1558986752
Name:COLYN NOUV, DPM PLLC
Entity Type:Organization
Organization Name:COLYN NOUV, DPM PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:COLYN
Authorized Official - Middle Name:
Authorized Official - Last Name:NOUV
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:510-283-1932
Mailing Address - Street 1:34627 SE SWENSON DR STE 101
Mailing Address - Street 2:
Mailing Address - City:SNOQUALMIE
Mailing Address - State:WA
Mailing Address - Zip Code:98065-5199
Mailing Address - Country:US
Mailing Address - Phone:510-283-1932
Mailing Address - Fax:
Practice Address - Street 1:34627 SE SWENSON DR STE 101
Practice Address - Street 2:
Practice Address - City:SNOQUALMIE
Practice Address - State:WA
Practice Address - Zip Code:98065-5199
Practice Address - Country:US
Practice Address - Phone:510-283-1932
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-12
Last Update Date:2020-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Multi-Specialty