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General NPI Number Information
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NPI Number | 1407893969
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Entity Type | Individual
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Provider Name | STANLEY ALBERT KOPP M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/01/2006
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Last Update Date | 02/07/2012
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Provider Practice Location Address
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Address Line | 12911 120TH AVE NE SUITE C-50
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City | KIRKLAND
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State | WA
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Zip | 98034-3027
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Country | US
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Telephone | 425-823-1052
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Fax | 425-899-4243
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Provider Business Mailing Address
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Address Line | PO BOX 1302
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City | MUKILTEO
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State | WA
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Zip | 98275-1302
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Country | US
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Telephone | 425-514-8070
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Fax | 425-710-0332
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | MD00025061
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License Number State | WA
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