Provider Demographics
NPI:1316142862
Name:COOPER, EMILY L (MD)
Entity type:Individual
Prefix:DR
First Name:EMILY
Middle Name:L
Last Name:COOPER
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 1:400 N 34TH ST
Mailing Address - Street 2:300
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98103-8600
Mailing Address - Country:US
Mailing Address - Phone:206-632-4581
Mailing Address - Fax:
Practice Address - Street 1:400 N 34TH ST
Practice Address - Street 2:300
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98103-8600
Practice Address - Country:US
Practice Address - Phone:206-632-4581
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00035483207QS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAE70157Medicare UPIN