Provider Demographics
NPI:1770721870
Name:POPPLETON, LANDON EUGENE (PHD, JD)
Entity type:Individual
Prefix:DR
First Name:LANDON
Middle Name:EUGENE
Last Name:POPPLETON
Suffix:
Gender:M
Credentials:PHD, JD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:814 NE 87TH AVE
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98664-1915
Mailing Address - Country:US
Mailing Address - Phone:360-910-1522
Mailing Address - Fax:360-326-1522
Practice Address - Street 1:814 NE 87TH AVE
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98664-1915
Practice Address - Country:US
Practice Address - Phone:360-910-1522
Practice Address - Fax:360-326-1522
Is Sole Proprietor?:No
Enumeration Date:2009-01-27
Last Update Date:2022-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPY 60041144103TF0200X, 103TC0700X, 103TF0000X, 103TF0200X, 103TP2701X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensic
No103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamily
No103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup Psychotherapy