Individual
BRADLEY J COOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
16528 E DESMET CT STE 3100, SPOKANE VALLEY, WA 99216-3522
(509) 944-9440
(509) 227-7070
Mailing address
PO BOX 421, LIBERTY LAKE, WA 99019-0421
(866) 747-2455
(509) 227-7070
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
64870-20
WI
207Q00000X
Family Medicine Physician
Primary
MD60734082
WA
390200000X
Student in an Organized Health Care Education/Training Program
64870-20
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1770957854
BCBSWI
WI
05
—
1770957854
—
WI
01
—
COOKBRA
MERCYCARE INSURANCE
WI
Enumeration date
11/30/2015
Last updated
07/21/2022
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