Provider Demographics
NPI:1437345196
Name:HOPPA, MARY E (MSW)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:E
Last Name:HOPPA
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7720 44TH AVE W
Mailing Address - Street 2:
Mailing Address - City:MUKILTEO
Mailing Address - State:WA
Mailing Address - Zip Code:98275-2720
Mailing Address - Country:US
Mailing Address - Phone:425-879-5283
Mailing Address - Fax:425-322-5531
Practice Address - Street 1:7720 44TH AVE W
Practice Address - Street 2:
Practice Address - City:MUKILTEO
Practice Address - State:WA
Practice Address - Zip Code:98275-2720
Practice Address - Country:US
Practice Address - Phone:425-879-5283
Practice Address - Fax:425-322-5531
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-17
Last Update Date:2017-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW000041491041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1980879Medicaid