Provider Demographics
NPI:1538603121
Name:KOPLAN, JULIE (LMP)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:KOPLAN
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6710 GREENWOOD AVE N
Mailing Address - Street 2:APT #2
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98103-5248
Mailing Address - Country:US
Mailing Address - Phone:508-454-3810
Mailing Address - Fax:
Practice Address - Street 1:8423 MUKILTEO SPEEDWAY
Practice Address - Street 2:SUITE 101
Practice Address - City:MUKILTEO
Practice Address - State:WA
Practice Address - Zip Code:98275-3237
Practice Address - Country:US
Practice Address - Phone:425-423-0878
Practice Address - Fax:425-669-9538
Is Sole Proprietor?:No
Enumeration Date:2016-12-15
Last Update Date:2016-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60711339225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist