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General NPI Number Information
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NPI Number | 1275673956
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Entity Type | Organization
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Legal Business Name | JEFF COOPER DO PLLC
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Dates
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Enumeration Date | 02/08/2007
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Last Update Date | 04/10/2025
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Provider Practice Location Address
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Address Line | 4300 TALBOT ROAD S SUITE 104
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City | RENTON
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State | WA
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Zip | 98055-5767
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Country | US
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Telephone | 425-228-1123
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Fax | 833-973-3950
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Provider Business Mailing Address
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Address Line | 4300 TALBOT ROAD S SUITE 104
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City | RENTON
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State | WA
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Zip | 98055-5767
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Country | US
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Telephone | 425-228-1123
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Fax | 425-228-5791
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Authorized Official
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Title or Position | MANAGER/BILLER
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Name | MS. ANA DE GUZMAN
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Credential | DO
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Telephone | 206-766-0613
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | OP00001995
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License Number State | WA
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