Organization
BLUE MOUNTAIN GENETICS CLINIC, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PATRICIA S. COOPER PHD (SOLE MEMBER)
(509) 525-1302
Entity
Organization
Contact information
Practice address
320 W WILLOW ST, WALLA WALLA, WA 99362-2922
(509) 525-1302
(509) 522-9448
Mailing address
320 W WILLOW ST, WALLA WALLA, WA 99362-2922
(509) 525-1302
(509) 522-9448
Taxonomy
Speciality
Code
Description
License number
State
170300000X
Genetic Counselor (M.S.)
Primary
—
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7110661
—
WA
Enumeration date
10/05/2005
Last updated
08/22/2020
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