Basic Information
| Provider Information | |||||||||
| NPI: | 1487660726 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | COOPER | ||||||||
| FirstName: | ANNE | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9040A JACKSON AVE | ||||||||
| Address2: | |||||||||
| City: | TACOMA | ||||||||
| State: | WA | ||||||||
| PostalCode: | 984310001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2534775053 | ||||||||
| FaxNumber: | 2534775098 | ||||||||
| Practice Location | |||||||||
| Address1: | 9040A JACKSON AVE | ||||||||
| Address2: | |||||||||
| City: | TACOMA | ||||||||
| State: | WA | ||||||||
| PostalCode: | 984314238 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2534775053 | ||||||||
| FaxNumber: | 2534775098 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/31/2006 | ||||||||
| LastUpdateDate: | 09/17/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | J7456 | TX | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | MD00031376 | WA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.