COPPER CREEK MEDICAL, INC. (NPI# 1942558739) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942558739 |
| Entity Type | Organization |
| Organization Name | COPPER CREEK MEDICAL, INC. |
| Practice Address |
18905 33rd Ave W Suite 111 Lynnwood WA 98036-4715 |
| Mailing Address |
21222 30th Dr Se Suite 210 Bothell WA 98021-7019 |
| Practice Telephone | 4253399393 |
| Practice Fax Number | 4253399325 |
| Mailing Telephone | 2066211982 |
| Mailing Fax Number | 4258200831 |
| Enumeration Date | 2012-08-27 |
| Last Update Date | 2012-08-27 |
| Authorized Official Name | MR. ALFRED TALL (PRESIDENT) |
| Authorized Official Telephone | 5099984309 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518215391 | Copper Creek Medical, Inc. | Durable Medical Equipment & Medical Supplies | 20038 68th Ave S, Suite 101, Kent, WA 98032-2154 | 2012-08-27 |
| 1669720454 | Copper Creek Medical, Inc. | Durable Medical Equipment & Medical Supplies | 3411 Fruitvale Blvd, Yakima, WA 98902-7320 | 2012-08-27 |
| 1023366812 | Copper Creek Medical, Inc. | Durable Medical Equipment & Medical Supplies | 3410 E Desmet Ave, Suite B, Spokane, WA 99202-4514 | 2012-08-27 |
| 1851650915 | Copper Creek Medical, Inc. | Durable Medical Equipment & Medical Supplies | 17700 Se 272nd St, Suite 350, Covington, WA 98042-4951 | 2012-05-10 |
| 1700145869 | Copper Creek Medical, Inc. | Durable Medical Equipment & Medical Supplies | 1818 S Union Ave, Suite 2b, Tacoma, WA 98405-1953 | 2012-05-10 |
| Street Address |
18905 33RD AVE W SUITE 111 |
| City | LYNNWOOD |
| State | WA |
| Zip Code | 98036-4715 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881673812 | Mark A Janczakowski | Dentist | 18905 33rd Ave W, #201, Lynnwood, WA 98036 | 2006-01-10 |
| 1457330490 | Mark T Hetzer | Dentist | 18905 33rd Ave W, #201, Lynnwood, WA 98036-4730 | 2006-01-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396342630 | Zachary Perry | Behavior Technician | 4100 Veterans Way, Unit 100, Lynnwood, WA 98036 | 2020-10-08 |
| 1942832795 | Alexis Michelle Solomon-winne | Behavior Technician | 4100 Veterans Way Unit 100 Lynnwood, Wa 98036 United S, Lynnwood, WA 98036 | 2020-02-10 |
| 1881239028 | Endc Pllc | Psychologist | 19217 36th Ave W. Suite 219, Lynnwood, WA 98036 | 2019-11-12 |
| 1225507866 | Kyung Suk Seo | Massage Therapist | 18904 Hwy 99, Ste. K, Lynnwood, WA 98036 | 2018-11-13 |
| 1790270197 | Kabal Sriviboon | Behavior Technician | 20818 44th Ave W Suite 270, Lynnwood, WA 98036 | 2018-06-27 |
| 1992206148 | Kendal Ilyse Borison | Behavioral Analyst | 4100 194th Se, Suite 100, Lynnwood, WA 98036 | 2018-02-23 |
| 1205352515 | Doug Brant | Registered Nurse | 19931 Cypress Way, Lynnwood, WA 98036 | 2017-08-17 |
| 1588184980 | Evergreen Recovery Centers-lynnwood Detox | Substance Abuse Rehabilitation Facility | 20508 56th Ave W, Lynnwood, WA 98036 | 2017-06-27 |
| 1699213439 | Patrick J. Pacyga | Dentist | 19620 Wa-99, Suite 106, Lynnwood, WA 98036 | 2017-02-01 |
| 1134676646 | Fiona Green | Occupational Therapy Assistant | 21503 8th Place W, A, Lynnwood, WA 98036 | 2016-09-01 |
| Find all providers in zip 98036 | ||||
| Taxonomy Code | 332B00000X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient’s use in the home and that are usable for an extended period of time. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295352557 | North Seattle Medical Supply | Durable Medical Equipment & Medical Supplies | 19502 48th Ave W Ste B, Lynnwood, WA 98036-5507 | 2020-07-01 |
| 1437783156 | Medella Northwest | Durable Medical Equipment & Medical Supplies | 2130 160th Pl Sw, Lynnwood, WA 98087-2539 | 2020-03-03 |
| 1023478021 | Washington Cvs Pharmacy L L C | Durable Medical Equipment & Medical Supplies | 19507 Highway 99, Lynnwood, WA 98036-5981 | 2016-03-03 |
| 1386992576 | Walmart Inc. | Durable Medical Equipment & Medical Supplies | 17222 Highway 99, Lynnwood, WA 98037-3170 | 2012-08-21 |
| 1841207743 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 16824 Highway 99, Lynnwood, WA 98037-3167 | 2006-08-02 |
| 1437165727 | Thrifty Payless Inc | Durable Medical Equipment & Medical Supplies | 18600-b 33rd Avenue West, Alderwood Plaza Shopping Center, Lynnwood, WA 98037-4715 | 2006-07-31 |
| 1396751608 | Thrifty Payless Inc | Durable Medical Equipment & Medical Supplies | 7500 196th Street Southwest, Suite A, Lynnwood, WA 98036-5090 | 2006-07-31 |
| 1730194705 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 16423 Larch Way, Lynnwood, WA 98037-8108 | 2006-07-29 |
| 1093720062 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 20725 Highway 99, Lynnwood, WA 98036-7454 | 2006-07-29 |
| 1093737785 | Washington Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 18305 Alderwood Mall Pkwy, Lynnwood, WA 98037-3961 | 2006-07-24 |
| Find all providers in LYNNWOOD | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.