Provider Demographics
NPI:1942754486
Name:COLEMAN FAMILY SERVICES
Entity Type:Organization
Organization Name:COLEMAN FAMILY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:HAYWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:COLEMAN
Authorized Official - Suffix:JR
Authorized Official - Credentials:LMHCA
Authorized Official - Phone:206-683-3703
Mailing Address - Street 1:15 S GRADY WAY
Mailing Address - Street 2:SUITE 305
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98057-3220
Mailing Address - Country:US
Mailing Address - Phone:425-235-9386
Mailing Address - Fax:425-277-9883
Practice Address - Street 1:15 SOUTH GRADY WAY
Practice Address - Street 2:SUITE 241
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98057
Practice Address - Country:US
Practice Address - Phone:425-235-9386
Practice Address - Fax:425-277-9883
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-13
Last Update Date:2019-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA276251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health