Individual
OLIVIA JUNE COOK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
51385 SW OLD PORTLAND RD STE E, SCAPPOOSE, OR 97056-4062
(503) 543-7768
Mailing address
790 REMINGTON BLVD, BOLINGBROOK, IL 60440-4909
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
64019
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
64019
OREGON BOARD OF PHYSICAL THERAPY LICENSE NUMBER
OR
Enumeration date
07/30/2021
Last updated
10/10/2024
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