Individual
JESSICA LEE COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
907 GEORGIANA ST, PORT ANGELES, WA 98362-3911
(360) 565-0550
(360) 565-0551
Mailing address
PO BOX 850, PORT ANGELES, WA 98362-0146
(360) 565-0550
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP61113220
WA
363LF0000X
Family Nurse Practitioner
137989
MT
Other
Enumeration date
02/04/2019
Last updated
01/05/2021
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