Individual
HEATHER LYNN COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
10004 204TH AVE E, SUITE 1300, BONNEY LAKE, WA 98391-6535
(253) 848-8797
(253) 826-1264
Mailing address
1706 S MERIDIAN, STE 120, PUYALLUP, WA 98371
(253) 848-8797
(253) 446-3239
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
9800822
NC
208000000X
Pediatrics Physician
Primary
MD00049019
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8497737
—
WA
05
—
89126CE
—
NC
Enumeration date
03/10/2006
Last updated
11/14/2011
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