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NPI Code Detail

MEDICARE: TRACY MICHELLE COOPER LM

MEDICARE: TRACY MICHELLE COOPER LM
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1176B00000XMidwifeMW0024WA

General Provider Information

NPI Number : 1205050507
Entity Type Code : Individual
Provider Name (Legal Business Name) : TRACY MICHELLE COOPER LM
Provider Business Mailing Address
First Line : 2200 24TH AVE E
Second Line :
City : SEATTLE
State : WA
Zip : 98112-3050
Country : US
Telephone Number : 206-325-0527
Fax Number : 206-328-2310
Provider Business Practice Location Address
First Line : 2200 24TH AVE E
Second Line :
City : SEATTLE
State : WA
Zip : 98112-3050
Country : US
Telephone Number : 206-325-0527
Fax Number : 206-328-2310
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/11/2007
Last Update Date : 07/08/2007

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Directions to “ TRACY MICHELLE COOPER LM” Practice Location

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