Basic Information
| Provider Information | |||||||||
| NPI: | 1215495205 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CORONADO | ||||||||
| FirstName: | DAYMAI | ||||||||
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| Mailing Information | |||||||||
| Address1: | 11803 NE 124TH AVE APT D52 | ||||||||
| Address2: | |||||||||
| City: | VANCOUVER | ||||||||
| State: | WA | ||||||||
| PostalCode: | 986822094 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5035017543 | ||||||||
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| Practice Location | |||||||||
| Address1: | STE CONSULTANTS, LLC | ||||||||
| Address2: | 3650 MT. DIABLO BLVD., SUITE 107 | ||||||||
| City: | LAFAYETTE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 945492094 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5106659700 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/08/2019 | ||||||||
| LastUpdateDate: | 03/08/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106S00000X | Y |
No ID Information.