Provider Demographics
NPI:1104874270
Name:HOPPE, ROBERTA LYNN (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERTA
Middle Name:LYNN
Last Name:HOPPE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 E MANITOBA AVE
Mailing Address - Street 2:
Mailing Address - City:ELLENSBURG
Mailing Address - State:WA
Mailing Address - Zip Code:98926-3885
Mailing Address - Country:US
Mailing Address - Phone:509-925-6100
Mailing Address - Fax:509-925-7604
Practice Address - Street 1:700 E MANITOBA AVE
Practice Address - Street 2:
Practice Address - City:ELLENSBURG
Practice Address - State:WA
Practice Address - Zip Code:98926-3885
Practice Address - Country:US
Practice Address - Phone:509-925-6100
Practice Address - Fax:509-925-7604
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2025-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00037808207RC0001X
MN47516207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN892953000Medicaid
MN060002608Medicare PIN
MNH16260Medicare UPIN