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Individual

EMMA ROSE COOPER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PSS

Contact information

Practice address
1132 SW 13TH AVE, PORTLAND, OR 97205-1703
(503) 535-3860
Mailing address
1132 SW 13TH AVE, PORTLAND, OR 97205-1703
(503) 535-3860

Taxonomy

Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
000104590
OR

Other

Enumeration date
02/26/2021
Last updated
02/26/2021
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