Individual
MATT COPPLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHR
Contact information
Practice address
26625 225TH AVE SE, MAPLE VALLEY, WA 98038-7448
(206) 948-5354
Mailing address
PO BOX 43, MAPLE VALLEY, WA 98038-0043
(425) 358-4644
(425) 947-9844
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
IHS.FS.60506716
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
IHS.FS.60606716
DEPARTMENT OF HEALTH
WA
Enumeration date
05/21/2015
Last updated
05/21/2015
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