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Individual

THOMAS R COOKE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
4254 JACKSON HWY, CHEHALIS, WA 98532-8424
(360) 996-6603
(360) 996-6604
Mailing address
2690 NE KRESKY AVE, CHEHALIS, WA 98532-2412
(360) 330-9595
(360) 330-9560

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
OP00000823
WA
208D00000X
General Practice Physician
Primary
OP00000823
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2182956
WA
Enumeration date
10/04/2006
Last updated
02/08/2024
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