Provider Demographics
NPI:1154032092
Name:KOPATICH, ANNA ELIZABETH
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:ELIZABETH
Last Name:KOPATICH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22714 20TH DR SE APT G306
Mailing Address - Street 2:
Mailing Address - City:BOTHELL
Mailing Address - State:WA
Mailing Address - Zip Code:98021-7249
Mailing Address - Country:US
Mailing Address - Phone:303-981-3841
Mailing Address - Fax:
Practice Address - Street 1:16030 BOTHELL EVERETT HWY STE 140
Practice Address - Street 2:
Practice Address - City:MILL CREEK
Practice Address - State:WA
Practice Address - Zip Code:98012-1273
Practice Address - Country:US
Practice Address - Phone:425-338-9005
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-12
Last Update Date:2022-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist