| Doctor Name: | ROBERT KOPEC |
| NPI Number: | 1053746867 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | DNP, ARNP |
| License Number: | AP60411730 |
| Business Practice Address: | 4009 Bridgeport Way W Suite 1a University Place, WA - 984664326 |
| Business Phone Number: | 2535036761 |
| Business Fax Number: | |
| Mailing Address: | 4009 Bridgeport Way W, Suite 1a UNIVERSITY PLACE |
| State: | WA |
| Postal Code: | 984664326 |
| Phone Number: | 2535036761 |
| Fax Number: | |
| NPI Enumeration Date: | 09/11/2013 |
| NPI Last Update Date: | 01/11/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0808X |
| License Number: | AP60411730 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Psych/Mental Health |
| Taxonomy Definition: | |