Basic Information
| Provider Information | |||||||||
| NPI: | 1689881302 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MEYER | ||||||||
| FirstName: | COLIN | ||||||||
| MiddleName: | R | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | LMP, NCTMB | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1620 SE SUMMIT CT | ||||||||
| Address2: | SUMMIT THERAPY | ||||||||
| City: | PULLMAN | ||||||||
| State: | WA | ||||||||
| PostalCode: | 991635540 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5093325106 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1620 SE SUMMIT CT | ||||||||
| Address2: | SUMMIT THERAPY | ||||||||
| City: | PULLMAN | ||||||||
| State: | WA | ||||||||
| PostalCode: | 991635540 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5093325106 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/16/2007 | ||||||||
| LastUpdateDate: | 08/29/2008 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225700000X | MA00023048 | WA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Massage Therapist |
No ID Information.