Organization
COPESTONE PSYCHIATRIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WARREN SHADKO (OWNER)
(828) 393-9025
Entity
Organization
Contact information
Practice address
11335 NE 122ND WAY STE 105, KIRKLAND, WA 98034-6933
(828) 393-9025
Mailing address
224 THOMPSON ST, PMB 218, HENDERSONVILLE, NC 28792-2806
(828) 393-9025
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
11/06/2020
Last updated
11/06/2020
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