Organization
COPPERSMITH ORTH & SPORTS PT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PENNY S COPPERSMITH PT (PRESIDENT)
(206) 524-6702
Entity
Organization
Contact information
Practice address
5025 25TH AVE NE, SUITE 201, SEATTLE, WA 98105-4151
(206) 524-6702
(206) 524-6703
Mailing address
5025 25TH AVE NE, SUITE 201, SEATTLE, WA 98105-4151
(206) 524-6702
(206) 524-6703
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
PT00002380
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
911891680
PREMERA BLUE CROSS
WA
Enumeration date
03/10/2007
Last updated
05/18/2015
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