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Individual
KORDELL ALAN KOEPNICK
Active
Individual
KORDELL ALAN KOEPNICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA-2450
ID
363A00000X
Physician Assistant
PA219548
OR
363A00000X
Physician Assistant
PA6140460
WA
363AM0700X
Medical Physician Assistant
PA-2450
ID
363AM0700X
Medical Physician Assistant
PA219548
OR
363AM0700X
Medical Physician Assistant
PA61460460
WA
363AS0400X
Surgical Physician Assistant
PA-2450
ID
363AS0400X
Surgical Physician Assistant
PA219548
OR
363AS0400X
Surgical Physician Assistant
PA61460460
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1770289621
—
ID
05
—
2261987
—
WA
05
—
500841624
—
OR
Enumeration date
02/02/2023
Last updated
05/05/2026
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