Provider Demographics
NPI:1184709537
Name:COOPER, STEPHANIE G (MD)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:G
Last Name:COOPER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:325 9TH AVE
Mailing Address - Street 2:HARBORVIEW MEDICAL CENTER BOX 359748
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98104-2420
Mailing Address - Country:US
Mailing Address - Phone:206-744-8712
Mailing Address - Fax:206-744-8712
Practice Address - Street 1:325 9TH AVE
Practice Address - Street 2:HARBORVIEW MEDICAL CENTER BOX 359748
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-2420
Practice Address - Country:US
Practice Address - Phone:206-744-8712
Practice Address - Fax:206-744-2224
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2024-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00032840207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA060055501OtherRR MEDICARE
WA8232563Medicaid
F71630Medicare UPIN
WAAB12431Medicare PIN