Provider Demographics
NPI:1831490671
Name:MCCOY, MOLLY FRANCES
Entity Type:Individual
Prefix:
First Name:MOLLY
Middle Name:FRANCES
Last Name:MCCOY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MOLLY
Other - Middle Name:FRANCES
Other - Last Name:COOPER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:16218 16TH AVE SW
Mailing Address - Street 2:
Mailing Address - City:BURIEN
Mailing Address - State:WA
Mailing Address - Zip Code:98166-2860
Mailing Address - Country:US
Mailing Address - Phone:678-997-1029
Mailing Address - Fax:206-494-7435
Practice Address - Street 1:126 SW 148TH ST STE C100
Practice Address - Street 2:PMB 275
Practice Address - City:BURIEN
Practice Address - State:WA
Practice Address - Zip Code:98166-1984
Practice Address - Country:US
Practice Address - Phone:678-997-1029
Practice Address - Fax:206-494-7435
Is Sole Proprietor?:No
Enumeration Date:2010-11-10
Last Update Date:2014-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist
No222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist