NPIMap

Organization Active NPI

Copper Creek Medical, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Lynnwood, WA
National Provider Identifier
1942558739
Registry record updated Aug 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
COPPER CREEK MEDICAL, INC.
Practice address
18905 33Rd Ave W
Suite 111
Lynnwood, WA 98036-4715
Phone
(425) 339-9393
Fax
(425) 339-9325
NPI assigned
Aug 27, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2012

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

Authorized official

Name
Mr. Alfred Tall
Title
President
Phone
(509) 998-4309

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Primary

Addresses

Primary practice location

18905 33Rd Ave W
Suite 111
Lynnwood, WA 98036-4715

Mailing address

21222 30TH Dr SE
Suite 210
Bothell, WA 98021-7019
Phone (206) 621-1982

National Provider Directory

National Provider Directory
Tax ID family
Copper Creek Medical Inc9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1346025600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1346025600000",
    "number": "1942558739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21222 30TH DR SE",
            "address_2": "SUITE 210",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980217019",
            "telephone_number": "206-621-1982",
            "fax_number": "425-820-0831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18905 33RD AVE W",
            "address_2": "SUITE 111",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980364715",
            "telephone_number": "425-339-9393",
            "fax_number": "425-339-9325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COPPER CREEK MEDICAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-27",
        "last_updated": "2012-08-27",
        "status": "A",
        "authorized_official_last_name": "TALL",
        "authorized_official_first_name": "ALFRED",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "509-998-4309",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynnwood, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2012; 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.