Provider Demographics
NPI:1417139478
Name:COPE, SANDRA CAROL (PT)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:CAROL
Last Name:COPE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1549 GEORGIA AVENUE SE
Mailing Address - Street 2:SUITE A
Mailing Address - City:RICHLAND
Mailing Address - State:WA
Mailing Address - Zip Code:99352
Mailing Address - Country:US
Mailing Address - Phone:509-735-1062
Mailing Address - Fax:509-737-8492
Practice Address - Street 1:1549 GEORGIA AVENUE SE
Practice Address - Street 2:SUITE A
Practice Address - City:RICHLAND
Practice Address - State:WA
Practice Address - Zip Code:99352
Practice Address - Country:US
Practice Address - Phone:509-735-1062
Practice Address - Fax:509-737-8492
Is Sole Proprietor?:No
Enumeration Date:2007-12-03
Last Update Date:2007-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00003483225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist