Individual
MEGAN COPPOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CPM, LDM
Contact information
Practice address
504 NE GOING ST, PORTLAND, OR 97211-3915
(503) 954-5026
Mailing address
504 NE GOING ST, PORTLAND, OR 97211-3915
(503) 954-5026
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary
DEM-LD-10173904
OR
Other
Enumeration date
01/19/2016
Last updated
01/19/2016
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