Individual
POPPY JEAN COGBURN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
516 E 1ST ST, ABERDEEN, WA 98520-4106
(360) 721-3591
Mailing address
1511 WESTPORT RD, ABERDEEN, WA 98520-6444
(360) 593-9013
Taxonomy
Speciality
Code
Description
License number
State
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
Primary
RN00160337
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RN00160337
NURSE LICENSURE
WA
Enumeration date
07/23/2021
Last updated
07/23/2021
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