MEDICARE: EMILY L COOPER MD

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
1	207R00000X	Internal Medicine Physician	MD00043364	WA

General Provider Information

NPI Number	:	1780614370
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMILY L COOPER MD

Provider Business Mailing Address
First Line	:	3216 NE 45TH PL STE 213
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98105-4028
Country	:	US
Telephone Number	:	206-524-3091
Fax Number	:	206-745-0101

Provider Business Practice Location Address
First Line	:	3216 NE 45TH PL STE 213
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98105-4028
Country	:	US
Telephone Number	:	206-524-3091
Fax Number	:	206-745-0101

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/03/2006
Last Update Date	:	05/07/2025

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