Individual
DR. EILEEN LOUISE POUPORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
9040 JACKSON AVE, TACOMA, WA 98433-9500
(253) 968-4848
Mailing address
3205 88TH ST E, TACOMA, WA 98446-2507
(253) 312-8923
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
AP30006358
WA
363LP2300X
Primary Care Nurse Practitioner
AP30006358
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0618PO
REGENCE BLUE SHIELD
WA
01
—
8938321
CRIME VICTIMS
WA
05
—
9635384
—
WA
Enumeration date
01/11/2006
Last updated
06/13/2016
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