Provider Demographics
NPI:1326294174
Name:DUPPER-KNOPER, TERRI (PMHNP)
Entity Type:Individual
Prefix:MS
First Name:TERRI
Middle Name:
Last Name:DUPPER-KNOPER
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:MS
Other - First Name:TERRI
Other - Middle Name:
Other - Last Name:DUPPER-KNOPER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PMHNP
Mailing Address - Street 1:1600 S COLUMBIAN WAY
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98108-1565
Mailing Address - Country:US
Mailing Address - Phone:206-768-5356
Mailing Address - Fax:
Practice Address - Street 1:1600 S COLUMBIAN WAY
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98108-1565
Practice Address - Country:US
Practice Address - Phone:206-768-5356
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-12
Last Update Date:2014-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60153971363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health