IndividualActive
Annie Coronado, PA
NPI 1154757359 · Medical Physician Assistant · Othello, WA
Provider details
- NPI number
- 1154757359
- Entity type
- Individual
- Primary specialty
- Medical Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- PA
- Sex
- Female
- Sole proprietor
- No
- License
- PA60415801 (WA)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Practice location
1515 E Columbia St
Othello, WA 99344-1846
Phone: (509) 488-5256
Fax: (509) 488-9939
Approximate (ZIP-level) locationGet directions
Mailing address
1515 E Columbia St
Othello, WA 99344-1846
Registry dates
- Enumerated
- 2013-09-19
- Last updated
- 2021-03-24
- Certified
- 2021-03-24
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.