Provider Demographics
NPI:1821860701
Name:KOPMAN, DAWN (LMT)
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:
Last Name:KOPMAN
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2817 NE CEDAR CREEK RD
Mailing Address - Street 2:
Mailing Address - City:WOODLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98674-2527
Mailing Address - Country:US
Mailing Address - Phone:360-605-8955
Mailing Address - Fax:
Practice Address - Street 1:2817 NE CEDAR CREEK RD
Practice Address - Street 2:
Practice Address - City:WOODLAND
Practice Address - State:WA
Practice Address - Zip Code:98674-2527
Practice Address - Country:US
Practice Address - Phone:360-605-8955
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-24
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61472174225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist