Organization
COOKE THERAPY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHERYL LYNNE COOKE PHD, DNP, PMHNP-BC (SOLE MBR)
(503) 847-5473
Entity
Organization
Contact information
Practice address
1125 SE MADISON ST STE 102, PORTLAND, OR 97214-3600
(503) 847-5473
(503) 925-5232
Mailing address
1125 SE MADISON ST STE 102, PORTLAND, OR 97214-3600
(503) 847-5473
(503) 925-5232
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500748734
—
OR
Enumeration date
03/28/2019
Last updated
08/02/2019
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