Individual
DR. HEATHER R COOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
1955 NW NORTHRUP ST, PORTLAND, OR 97209-1614
(503) 227-2020
(503) 222-0614
Mailing address
PO BOX 22009, PORTLAND, OR 97269-2009
(503) 558-7372
(503) 344-5140
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2628AT
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
150612
—
OR
Enumeration date
11/15/2005
Last updated
02/20/2021
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