Provider Demographics
NPI:1881192599
Name:COLEMAN, JAN ZYLSTRA
Entity Type:Individual
Prefix:
First Name:JAN
Middle Name:ZYLSTRA
Last Name:COLEMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JANET
Other - Middle Name:LORRAINE
Other - Last Name:ZYLSTRA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7414 128TH ST NE
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:WA
Mailing Address - Zip Code:98223-6274
Mailing Address - Country:US
Mailing Address - Phone:360-651-9518
Mailing Address - Fax:
Practice Address - Street 1:315 N FRENCH AVE
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:WA
Practice Address - Zip Code:98223-1317
Practice Address - Country:US
Practice Address - Phone:360-618-6200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-28
Last Update Date:2018-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOT00000644225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics