Individual
MR. EDWARD R COOK
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1601 NW HAWTHORNE AVE, GRANTS PASS, OR 97526-1041
(541) 472-4884
Mailing address
5319 SW WESTGATE DR, #241, PORTLAND, OR 97221-2432
(503) 297-7223
(503) 297-7603
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
—
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
125794
—
OR
Enumeration date
06/06/2006
Last updated
07/08/2007
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