Individual
JUSTIN O COOK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2801 N GANTENBEIN AVE, PORTLAND, OR 97227-1623
(503) 413-4870
Mailing address
825 NE MULTNOMAH ST, SUITE 1155, PORTLAND, OR 97232-2135
(503) 464-9034
(503) 464-9035
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
A82700
CA
207P00000X
Emergency Medicine Physician
M00044892
WA
207P00000X
Emergency Medicine Physician
Primary
MD25848
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
213596
—
OR
05
—
8433120
—
WA
Enumeration date
07/20/2006
Last updated
06/10/2013
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