| Doctor Name: | THOMAS R COOKE |
| NPI Number: | 1255427902 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | D.O. |
| License Number: | OP00000823 |
| Business Practice Address: | 4254 Jackson Hwy Chehalis, WA - 985328424 |
| Business Phone Number: | 3602623966 |
| Business Fax Number: | 3602623967 |
| Mailing Address: | 4254 Jackson Hwy, CHEHALIS |
| State: | WA |
| Postal Code: | 985328424 |
| Phone Number: | 3602623966 |
| Fax Number: | 3602623967 |
| NPI Enumeration Date: | 10/04/2006 |
| NPI Last Update Date: | 04/19/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QR1300X |
| License Number: | OP00000823 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | WA |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Rural Health |
| Taxonomy Definition: | |