Healthcare Provider Details

I. General information

NPI: 1811145246
Provider Name (Legal Business Name): TRISHA M COPELAND AUD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/27/2008
Last Update Date: 08/27/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9900 SE SUNNYSIDE RD FLOOR 2
CLACKAMAS OR
97015-9777
US

IV. Provider business mailing address

12160 SW JAEGER TER
BEAVERTON OR
97007-7240
US

V. Phone/Fax

Practice location:
  • Phone: 503-571-2942
  • Fax:
Mailing address:
  • Phone: 503-521-9834
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number022236
License Number StateOR

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: