Individual
MARCUS WARREN COOKSEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NPF
Contact information
Practice address
12710 SE DIVISION ST, PORTLAND, OR 97236-3134
(503) 988-3601
(503) 988-3015
Mailing address
421 SW OAK ST, STE. 210, PORTLAND, OR 97204-1817
(503) 988-7468
(503) 988-3015
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
NP17762
CA
363L00000X
Nurse Practitioner
Primary
NPF17762
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
096511
—
OR
05
—
22959
—
OR
Enumeration date
03/14/2008
Last updated
06/09/2014
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