Search › Idaho › 363A00000X
Kordell Koepnick, PA
NPI 1770289621 · on the registry since 2023 · sole proprietor
Practice
- Address
- 500 S 8th St
Boise, ID 83702 - Phone
- (855) 255-1750
- Fax
- (855) 255-0905
- Clinicians at this address
- 3
Additional practice sites
- 5200 Meadows Rd Ste 200, Lake Oswego, OR
- 413 29th St Ne Ste I, Puyallup, WA
Registry record
- Primary taxonomy
- 363A00000X
363A00000X
- Also registered as
- 363AM0700X
363AS0400X
363A00000X
363AM0700X
363AM0700X
363AS0400X
363AS0400X
363A00000X - Licence states on file
- ID, WA, OR
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2026-05-05
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Idaho