Provider Demographics
NPI:1649043712
Name:COATES, AMY ELIZABETH (MBBS)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:ELIZABETH
Last Name:COATES
Suffix:
Gender:F
Credentials:MBBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 85500 LOCKBOX 7642
Mailing Address - Street 2:SHRINERS HOSPITALS FOR CHILDREN PORTLAND
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19178-7642
Mailing Address - Country:US
Mailing Address - Phone:813-281-8115
Mailing Address - Fax:813-281-8056
Practice Address - Street 1:3101 SW SAM JACKSON PARK ROAD
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97239-3009
Practice Address - Country:US
Practice Address - Phone:503-221-3424
Practice Address - Fax:503-221-3490
Is Sole Proprietor?:No
Enumeration Date:2023-11-01
Last Update Date:2024-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program