Individual
HEATHER ALISON COOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
223 E POWELL BLVD, GRESHAM, OR 97030-7605
(503) 667-1500
Mailing address
14385 SE LUSTED RD, SANDY, OR 97055-7551
(575) 312-9391
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
20464
OR
Other
Enumeration date
10/23/2015
Last updated
10/23/2015
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