Provider Demographics
NPI:1780614370
Name:COOPER, EMILY L (MD)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:L
Last Name:COOPER
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3216 NE 45TH PL STE 213
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98105-4028
Mailing Address - Country:US
Mailing Address - Phone:206-524-3091
Mailing Address - Fax:206-745-0101
Practice Address - Street 1:3216 NE 45TH PL STE 213
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98105-4028
Practice Address - Country:US
Practice Address - Phone:206-524-3091
Practice Address - Fax:206-745-0101
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2025-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00043364207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
BC8713681OtherDEA