Kristie Jo Coppedge, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LW00007408 Issued in WA

Practice address

105 1/2 E 1St St
Port Angeles, WA 98362-2929

Phone

(360) 797-3564

NPI assigned

Feb 21, 2007

Last updated

Sep 22, 2026By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Kris Coppedge Professional name

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Jamestown S'Klallam Tribe

  dba Jamestown Family Health Clinic

  • Federally Qualified Health Center (FQHC)
  • Sequim, WA
  • NPI 1134181555
  Medicare reassignment NPD
• Jamestown S'Klallam Tribe

  dba Jamestown Family Health

  • Family Medicine Physician
  • Sequim, WA
  • NPI 1528809761
  NPD

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790035200000",
    "number": "1093850224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 1/2 E 1ST ST",
            "city": "PORT ANGELES",
            "state": "WA",
            "postal_code": "983622929",
            "telephone_number": "360-797-3564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 1/2 E 1ST ST",
            "city": "PORT ANGELES",
            "state": "WA",
            "postal_code": "983622929",
            "telephone_number": "360-797-3564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COPPEDGE",
        "first_name": "KRISTIE",
        "middle_name": "JO",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-21",
        "last_updated": "2026-09-22",
        "certification_date": "2026-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW00007408",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRIS",
            "last_name": "COPPEDGE",
            "credential": "LICSW",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Amy R Conway, EMT PARAMEDIC
• Sarah A Conway, LICSW
• Patrick Cook-Ray, RN
• Kelly Cook, LICSW
• Jessica Lee Cooper, NP
• Heather Corbin
• Adam Cota, M.D.
• Robert Christopher Cotner, ND
• Brigid Counts, LMSW
• Jennifer Lynn Courtney, LMP

• Clinical Social Worker in Port Angeles, WA
• Providers in Port Angeles, WA by specialty
• Clinical Social Worker in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.