| Coppedge Psychotherapy Inc | |
|
20102 Cedar Valley Rd Suite 107 Lynnwood WA 98036-6333 | |
| (425) 670-2102 | |
| (425) 670-8081 |
| Full Name | Coppedge Psychotherapy Inc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 20102 Cedar Valley Rd, Lynnwood, Washington |
| Authorized Official Name and Position | Kristie Jo Coppedge (OWNER) |
| Authorized Official Contact | 4256702102 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Coppedge Psychotherapy Inc 20102 Cedar Valley Rd Suite 107 Lynnwood WA 98036-6333 Ph: (425) 670-2102 | Coppedge Psychotherapy Inc 20102 Cedar Valley Rd Suite 107 Lynnwood WA 98036-6333 Ph: (425) 670-2102 |
| NPI Number | 1083995740 |
|---|---|
| Provider Enumeration Date | 09/07/2011 |
| Last Update Date | 10/27/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083995740 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | LW00007408 (Washington) | Primary |
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