Individual
JORDAN C COOK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
21 HAYDEN BRIDGE WAY, SPRINGFIELD, OR 97477-1305
(541) 600-2017
(541) 225-4864
Mailing address
21 HAYDEN BRIDGE WAY, SPRINGFIELD, OR 97477-1305
(541) 600-2017
(541) 225-4864
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
87784
MT
207N00000X
Dermatology Physician
Primary
DO221863
OR
390200000X
Student in an Organized Health Care Education/Training Program
—
OR
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/27/2015
Last updated
09/16/2024
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