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Individual

LAUREN ANNE COOPER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
4805 NE GLISAN ST, SUITE BG05, PORTLAND, OR 97213-2933
(503) 215-2392
(503) 215-6918
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
36051
MT
207R00000X
Internal Medicine Physician
MD28043
OR
207R00000X
Internal Medicine Physician
MD60555366
WA
208M00000X
Hospitalist Physician
Primary
MD28043
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
242411
OR
01
P00650717
RR MEDICARE (PH&S)-PMG
OR
Enumeration date
11/02/2006
Last updated
05/10/2021
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