Provider Demographics
NPI:1760982557
Name:COE, DEIRDRE C
Entity Type:Individual
Prefix:
First Name:DEIRDRE
Middle Name:C
Last Name:COE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13303 E MISSION AVE APT 220
Mailing Address - Street 2:
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99216-2793
Mailing Address - Country:US
Mailing Address - Phone:406-697-7296
Mailing Address - Fax:
Practice Address - Street 1:1224 E WESTVIEW CT
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99218-3813
Practice Address - Country:US
Practice Address - Phone:509-465-8800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-18
Last Update Date:2018-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAP160735132225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant