Provider Demographics
NPI:1700931110
Name:COLEMAN, DAWN MICHELLE (QMHA)
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:MICHELLE
Last Name:COLEMAN
Suffix:
Gender:F
Credentials:QMHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3973 NE 14TH AVE
Mailing Address - Street 2:LOWER UNIT
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97212-1357
Mailing Address - Country:US
Mailing Address - Phone:503-827-3949
Mailing Address - Fax:503-827-0931
Practice Address - Street 1:310 NW FLANDERS ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97209-3941
Practice Address - Country:US
Practice Address - Phone:503-827-3949
Practice Address - Fax:503-827-0931
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered171M00000XOther Service ProvidersCase Manager/Care Coordinator
Not Answered372600000XNursing Service Related ProvidersAdult Companion