Individual
CHARIS FAITH COOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
17019 NE 12TH AVE, RIDGEFIELD, WA 98642-5650
(360) 644-2088
Mailing address
17019 NE 12TH AVE, RIDGEFIELD, WA 98642-5650
(360) 644-2088
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
CB61673857
WA
106S00000X
Behavior Technician
—
—
Other
Enumeration date
03/04/2025
Last updated
05/13/2025
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