Provider Demographics
NPI:1639237290
Name:LANGE, COLENE CATHERINE (LMP CMP)
Entity Type:Individual
Prefix:MRS
First Name:COLENE
Middle Name:CATHERINE
Last Name:LANGE
Suffix:
Gender:F
Credentials:LMP CMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15404 E SPRINGFIELD AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99037-8569
Mailing Address - Country:US
Mailing Address - Phone:509-892-9800
Mailing Address - Fax:509-892-9998
Practice Address - Street 1:15404 E SPRINGFIELD AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99037-8569
Practice Address - Country:US
Practice Address - Phone:509-892-9800
Practice Address - Fax:509-892-9998
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00013092225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist