1790083525 NPI number — DR. CAROLYN DOREEN HOPPE PH.D.

Table of content: DR. CAROLYN DOREEN HOPPE PH.D. (NPI 1790083525)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1790083525 NPI number — DR. CAROLYN DOREEN HOPPE PH.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HOPPE
Provider First Name:
CAROLYN
Provider Middle Name:
DOREEN
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PH.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1790083525
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/02/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
325 9TH AVE
Provider Second Line Business Mailing Address:
BOX 359859
Provider Business Mailing Address City Name:
SEATTLE
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98104-2420
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
206-744-4614
Provider Business Mailing Address Fax Number:
206-744-6046

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
325 9TH AVE
Provider Second Line Business Practice Location Address:
BOX 359859
Provider Business Practice Location Address City Name:
SEATTLE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98104-2420
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-744-4614
Provider Business Practice Location Address Fax Number:
206-744-6046
Provider Enumeration Date:
03/02/2011

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 171M00000X , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 225C00000X , registered in the state of AR ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 266021 . This is a "WA LABOR AND INDUSTRIES" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".




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