COOKE THERAPY PLLC


Address: 1125 Se Madison St Ste 102, Portland, OR 97214-3600
Phone: 5038475473

COOKE THERAPY PLLC (NPI# 1548721871) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1548721871
Entity Type Organization
Organization Name COOKE THERAPY PLLC
Practice Address 1125 Se Madison St Ste 102
Portland
OR 97214-3600
Practice Telephone 5038475473
Practice Fax Number 5039255232
Mailing Telephone 5038475473
Mailing Fax Number 5039255232
Enumeration Date 2019-03-28
Last Update Date 2019-08-02
Authorized Official Name CHERYL LYNNE COOKE (SOLE MBR)
Authorized Official Telephone 5038475473
Authorized Official Credential PHD, DNP, PMHNP-
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LP0808X Nurse Practitioner
Specialization: Psych/Mental Health
Physician Assistants & Advanced Practice Nursing Providers

Other Provider Identifier

State Issuer Identifier Type Code
OR 500748734 05

Office Location

Street Address 1125 SE MADISON ST STE 102
City PORTLAND
State OR
Zip Code 97214-3600

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1629429311 Stephanie Tolentino Counselor 605 Se Cesar E Chavez Blvd., Portland, OR 97214 2016-06-24
1790141166 Marian Iris Dixon Massage Therapist 3810 Se Belmont St., Earthbody Wellness Center East, Portland, OR 97214 2016-01-14
1194194589 Lutheran Community Services Northwest Community/Behavioral Health 605 Se Cesar E Chavez Bld, Portland, OR 97214 2015-09-16
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Taxonomy Information

Taxonomy Code 363LP0808X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Psych/Mental Health

Taxonomy Definition

Definition to come...

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1104446681 Skycloud Psychiatry LLC Nurse Practitioner 106 South West Woods St, Portland, OR 97201 2020-04-24
1730712290 Lucy Anne Bloedon Nurse Practitioner 4020 Sw Iowa St, Portland, OR 97221-3423 2020-02-12
1346802733 Compass Psychiatric Wellness LLC Nurse Practitioner 4300 Ne Fremont St Ste 260, Portland, OR 97213-1100 2019-07-05
1245719541 Scott J Whited Nurse Practitioner 216 Vaughan St., Mcgeachy Hall, Portland, ME 04101 2018-08-08
1467969220 Nw Mind-body Wellness, LLC Nurse Practitioner 16986 Nw Lynch Ln, Portland, OR 97229-1221 2018-01-02
1811441348 Anthony Hoy Nurse Practitioner 5562 Se Pine St, Portland, OR 97215-1276 2016-08-12
1700241254 Jacqueline J Cole Nurse Practitioner 5228 Ne Hoyt St Ste 300, Portland, OR 97213-3055 2015-12-29
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Competitor

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City PORTLAND
Zip Code 97214

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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