| W Thomas Cooper, Md Ps | |
|
1200 N 14th Ave Suite 245 Pasco WA 99301-4182 | |
| (509) 547-9521 | |
| (509) 547-5983 |
| Full Name | W Thomas Cooper, Md Ps |
|---|---|
| Speciality | General Practice |
| Location | 1200 N 14th Ave, Pasco, Washington |
| Authorized Official Name and Position | W Thomas Cooper (PRESIDENT) |
| Authorized Official Contact | 5095479521 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| W Thomas Cooper, Md Ps 1200 N 14th Ave Suite 245 Pasco WA 99301-4182 Ph: (509) 547-9521 | W Thomas Cooper, Md Ps 1200 N 14th Ave Suite 245 Pasco WA 99301-4182 Ph: (509) 547-9521 |
| NPI Number | 1255515862 |
|---|---|
| Provider Enumeration Date | 12/19/2007 |
| Last Update Date | 01/08/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255515862 | NPI | - | NPPES |
| 1377100 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | MD00020136 (Washington) | Primary |
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