Individual
JUSTIN CHARLES COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1800 COOKS HILL RD, SUITE F, CENTRALIA, WA 98531-9072
(360) 827-6700
Mailing address
PO BOX 3360, PORTLAND, OR 97208-3360
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA60640498
WA
Other
Enumeration date
02/26/2015
Last updated
02/22/2017
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