Organization
COPPEDGE PSYCHOTHERAPY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS KRISTIE JO COPPEDGE LICSW (OWNER)
(425) 670-2102
Entity
Organization
Contact information
Practice address
20102 CEDAR VALLEY RD, SUITE 107, LYNNWOOD, WA 98036-6333
(425) 670-2102
(425) 670-8081
Mailing address
20102 CEDAR VALLEY RD, SUITE 107, LYNNWOOD, WA 98036-6333
(425) 670-2102
(425) 670-8081
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
LW00007408
WA
Other
Enumeration date
09/07/2011
Last updated
10/27/2011
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