Individual
BRIANNA PAUL COOK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
676 NE MAPLE AVE, REDMOND, OR 97756-8527
(541) 504-9577
Mailing address
PO BOX 1710, REDMOND, OR 97756-0516
(541) 516-4099
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
T-23-2791
OR
175T00000X
Peer Specialist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7605417
ODL
OR
Enumeration date
09/12/2023
Last updated
01/02/2025
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