Joshua Dylan Cooper, DC, LMT, CA

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CH60883035 Issued in WA

Practice address

19206 SE 1St St Ste 118
Camas, WA 98607-7478

Phone

(360) 433-9809

Fax

(360) 433-9809

NPI assigned

Jan 24, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1516752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537920000000",
    "number": "1225536279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19206 SE 1ST ST STE 118",
            "city": "CAMAS",
            "state": "WA",
            "postal_code": "986077478",
            "telephone_number": "360-433-9016",
            "fax_number": "360-433-9809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19206 SE 1ST ST STE 118",
            "city": "CAMAS",
            "state": "WA",
            "postal_code": "986077478",
            "telephone_number": "360-433-9809",
            "fax_number": "360-433-9809"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1359 NE 35th Ave",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972321941",
            "country_code": "US",
            "telephone_number": "503-783-8543",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COOPER",
        "first_name": "JOSHUA",
        "middle_name": "DYLAN",
        "name_prefix": "Dr.",
        "credential": "DC, LMT, CA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-01-24",
        "last_updated": "2018-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "OR",
            "license": "19927",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH60883035",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1225536279",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Melinda Christine Condon, M.A. CCC-SLP
• Jane Connell
• Shannon Carol Connell
• Deborah Marie Connors, MA, LMHC
• Cindy L. Cooper, RN, AE-C
• Lana May Coppernoll, EFDA, CDA
• Sasha Correia, MS
• Costco Wholesale Corporation
• Costco Wholesale Corporation
• Costco Wholesale Corporation

• Chiropractor in Camas, WA
• Providers in Camas, WA by specialty
• Chiropractor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2018; 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.