Provider Demographics
NPI:1699185348
Name:HOPP, DUANE FREDRICK (MD)
Entity Type:Individual
Prefix:DR
First Name:DUANE
Middle Name:FREDRICK
Last Name:HOPP
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:DUANE
Other - Middle Name:FREDRICK
Other - Last Name:HOPP
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:22612 126TH AVE E
Mailing Address - Street 2:
Mailing Address - City:GRAHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98338-6725
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:22612 126TH AVE E
Practice Address - Street 2:
Practice Address - City:GRAHAM
Practice Address - State:WA
Practice Address - Zip Code:98338-6725
Practice Address - Country:US
Practice Address - Phone:253-847-2326
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-03
Last Update Date:2014-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA00011125261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty