Provider Demographics
NPI:1912711128
Name:DR. COLLEEN VETTI, DPM, PLLC
Entity type:Organization
Organization Name:DR. COLLEEN VETTI, DPM, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:COLLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:VETTI
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:610-662-2417
Mailing Address - Street 1:1209 ORMISTON ST
Mailing Address - Street 2:
Mailing Address - City:WENATCHEE
Mailing Address - State:WA
Mailing Address - Zip Code:98801-3616
Mailing Address - Country:US
Mailing Address - Phone:610-662-2417
Mailing Address - Fax:
Practice Address - Street 1:1209 ORMISTON ST
Practice Address - Street 2:
Practice Address - City:WENATCHEE
Practice Address - State:WA
Practice Address - Zip Code:98801-3616
Practice Address - Country:US
Practice Address - Phone:509-866-6751
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-06
Last Update Date:2025-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1952754012Medicaid