Healthcare Provider Details
I. General information
NPI: 1487660726
Provider Name (Legal Business Name): ANNE COOPER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/31/2006
Last Update Date: 10/10/2025
Certification Date: 10/10/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
PO BOX 410
NEAH BAY WA
98357-0410
US
IV. Provider business mailing address
PO BOX 410
NEAH BAY WA
98357-0410
US
V. Phone/Fax
- Phone: 360-645-2233
- Fax: 360-645-2723
- Phone: 360-645-2233
- Fax: 360-645-2723
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | MD00031376 |
| License Number State | WA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | J7456 |
| License Number State | TX |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: