Healthcare Provider Details

I. General information

NPI: 1396207296
Provider Name (Legal Business Name): EMILY MARIE OPP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/01/2019
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 E MAIN ST
ELMA WA
98541-9560
US

IV. Provider business mailing address

PO BOX 2726
SPOKANE WA
99220-2726
US

V. Phone/Fax

Practice location:
  • Phone: 360-346-2222
  • Fax:
Mailing address:
  • Phone: 360-346-2222
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberPOD.0000905
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberPO70002565
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: