Jordan Kopsho

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

ATHL.A1.70142566 Issued in WA

Practice address

707 S Park St
Deer Park, WA 99006-7025

Phone

(509) 276-8811

NPI assigned

May 23, 2024

Last updated

Jul 27, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Deer Park Physical Therapy Inc

  • Physical Therapist
  • Deer Park, WA
  • NPI 1306903182
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1716422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785110400000",
    "number": "1003655481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1675 CRAB APPLE CIR",
            "city": "WEST RICHLAND",
            "state": "WA",
            "postal_code": "993535099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 S PARK ST",
            "city": "DEER PARK",
            "state": "WA",
            "postal_code": "990067025",
            "telephone_number": "509-276-8811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOPSHO",
        "first_name": "JORDAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-05-23",
        "last_updated": "2026-07-27",
        "certification_date": "2026-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "WA",
            "license": "ATHL.A1.70142566",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mayuko Kobayashi Jordan, RDH
• John H Kabosky, FNP-BC
• Debra Kay Keller, RPH
• Ryan Mayrus Kelso, DENTAL HYGENTIST
• Leah G Kobes-Jurgens, M.D.
• Jacquelynn Kuhn, LMHC
• Janelle Raye Lakman, LMP
• Kyra Larson
• Nicholas Blaine Nomura Lauderdale, MS
• Stephen M Laughlin, PA-C

• Athletic Trainer in Deer Park, WA
• Providers in Deer Park, WA by specialty
• Athletic Trainer in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.