Organization
DR. THOMAS COOKE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS R COOKE D.O. (DOCTOR)
(360) 736-4021
Entity
Organization
Contact information
Practice address
1217 MELLEN ST, CENTRALIA, WA 98531-1175
(360) 736-4021
(360) 736-3541
Mailing address
1217 MELLEN ST, CENTRALIA, WA 98531-1175
(360) 736-4021
(360) 736-3541
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
OP00000823
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7053861
—
WA
Enumeration date
12/11/2007
Last updated
01/10/2008
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