Coppola, Eilzabeth Convery
Coppola, Eilzabeth Convery is an individual health care provider with primary practice located at 600 Broadway St , Longview WA 98632-3256. She recently has only one registered license in Dietary & Nutritional Service Providers / Dietitian, Registered, which is considered as her primary health care specialty. Coppola, Eilzabeth Convery can be contacted via phone (360) 636-4943.Contact Information
Primary practice address
600 Broadway St
Longview WA 98632-3256
Phone: (360) 636-4943
Fax: (360) 414-7674
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dietary & Nutritional Service Providers / Dietitian, Registered | 133V00000X | DI00001498 | Washington |
Profile Details
| NPI number | 1578557195 |
|---|---|
| LBN Legal business name | Coppola, Eilzabeth Convery |
| Credentials | BS, MS |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 9th, 2005 |
| Last updated | Sep 24th, 2009 - about 15 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1578557195 | NPPES |
| Oregon | MEDICAID | 100431 | |
| Oregon | MEDICAID | 8331332 |
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