Individual
DR. THERESA MARIE KOPPIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3303 SW BOND AVE, PORTLAND, OR 97239-4501
(503) 346-1500
(503) 346-1501
Mailing address
3303 SW BOND AVE, PORTLAND, OR 97239-4501
(503) 346-1500
(503) 346-1501
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
154558
OR
208800000X
Urology Physician
2289321
NY
208800000X
Urology Physician
Primary
A068661
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1881794352
—
WA
05
—
500634566
—
OR
Enumeration date
09/25/2006
Last updated
08/31/2011
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