Individual
KIM MARIE NOWAK-COOPERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.D.,C.D.
Contact information
Practice address
CHILDREN'S HOSPITAL AND REGIONAL MEDICAL CENTER, 4800 SAND POINT WAY NE M/S 3726, SEATTLE, WA 98105-0371
(206) 987-2087
(206) 987-5087
Mailing address
7044 JONES AVE NW, SEATTLE, WA 98117-5655
(206) 781-0648
Taxonomy
Speciality
Code
Description
License number
State
133VN1004X
Pediatric Nutrition Registered Dietitian
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8261786
—
WA
01
—
DI00000095
CERTIFIED DIETITIAN
WA
Enumeration date
09/14/2006
Last updated
07/09/2007
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