Healthcare Provider Details

I. General information

NPI: 1457250789
Provider Name (Legal Business Name): REECE COPPINGER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/03/2026
Last Update Date: 11/05/2026
Certification Date: 11/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20812 BOTHELL EVERETT HWY
BOTHELL WA
98021-8404
US

IV. Provider business mailing address

20812 BOTHELL EVERETT HWY
BOTHELL WA
98021-8404
US

V. Phone/Fax

Practice location:
  • Phone: 425-398-0204
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPHRM.PH.70152907
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: