Individual
DEBORAH COOPER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
166 UNIT B 17TH AVE, SEATTLE, WA 98122
(206) 353-8330
Mailing address
166 17TH AVE UNIT B, SEATTLE, WA 98122-5787
(206) 353-8330
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
LL00003089
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0172058
LABOR AND INDUSTRIES
WA
01
—
3089CO
REGENCE BLUE SHIELD
WA
05
—
8337917
—
WA
Enumeration date
07/21/2005
Last updated
09/11/2008
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