Healthcare Provider Details

I. General information

NPI: 1669675526
Provider Name (Legal Business Name): JEFFREY COOPERMAN LMHC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/07/2007
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

615 E PIONEER STE 213
PUYALLUP WA
98372-3320
US

IV. Provider business mailing address

615 E PIONEER STE 213
PUYALLUP WA
98372-3320
US

V. Phone/Fax

Practice location:
  • Phone: 206-234-2144
  • Fax:
Mailing address:
  • Phone: 206-234-2144
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: