Healthcare Provider Details

I. General information

NPI: 1649070772
Provider Name (Legal Business Name): ISABELLA KOEPF
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/17/2025
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 E 8TH ST STE 110
VANCOUVER WA
98660-3294
US

IV. Provider business mailing address

9116 GRAVELLY LAKE DR SW STE 107 PMB 1664
LAKEWOOD WA
98499-3148
US

V. Phone/Fax

Practice location:
  • Phone: 206-569-5977
  • Fax:
Mailing address:
  • Phone: 206-569-5977
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLH70124075
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: