Individual
KIMBERLY H. COPELAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2121 NE 139TH ST, SUITE 200, VANCOUVER, WA 98686-2316
(360) 487-1777
(360) 487-1779
Mailing address
PO BOX 2077, PORTLAND, OR 97208-2077
(503) 413-3900
(503) 413-3710
Taxonomy
Speciality
Code
Description
License number
State
207PP0204X
Pediatric Emergency Medicine (Emergency Medicine) Physician
MD21409
OR
208000000X
Pediatrics Physician
Primary
MD00044472
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MD00044472
WA STATE LICENSE
WA
05
—
PENDING
—
WA
Enumeration date
07/21/2006
Last updated
10/12/2011
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