Provider Demographics
NPI:1255606356
Name:COLEMAN, HAYWARD JR (BA LIBERAL ARTS)
Entity type:Individual
Prefix:MR
First Name:HAYWARD
Middle Name:
Last Name:COLEMAN
Suffix:JR
Gender:M
Credentials:BA LIBERAL ARTS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 S GRADY WAY
Mailing Address - Street 2:SUITE 533
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:
Practice Address - Street 1:15 S GRADY WAY
Practice Address - Street 2:SUITE 533
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98057-3220
Practice Address - Country:US
Practice Address - Phone:425-235-9386
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-21
Last Update Date:2012-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor