Individual
LISA M COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
125 16TH AVE E, SEATTLE, WA 98112-5211
(206) 326-3000
Mailing address
125 16TH AVE E, SEATTLE, WA 98112-5211
(206) 326-3000
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
M4006
TX
207P00000X
Emergency Medicine Physician
MD60187261
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
184044902
—
TX
05
—
184044904
—
TX
01
—
8AC842
BCBSTX PROVIDER NUMBER
TX
Enumeration date
05/03/2006
Last updated
04/05/2021
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