Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QS0010X | Family Doctor - Sports Medicine | MD00035483 | WA |
NPI | 1316142862 |
---|---|
Provider Name | Dr. Emily L Cooper |
First Address | Seattle, WA 98103-8600 |
Second Address | Seattle, WA 98103-8600 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/06/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E70157 | (02) | WA |