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Individual

DR. JOSHUA DYLAN COOPER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DC, LMT, CA

Contact information

Practice address
19206 SE 1ST ST STE 118, CAMAS, WA 98607-7478
(360) 433-9809
(360) 433-9809
Mailing address
19206 SE 1ST ST STE 118, CAMAS, WA 98607-7478
(360) 433-9016
(360) 433-9809

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CH60883035
WA
225700000X
Massage Therapist
19927
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1225536279
WA
Enumeration date
01/24/2018
Last updated
09/26/2018
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