Provider Demographics
NPI:1639420110
Name:COOK, KATHRYN DENISE (MSW)
Entity Type:Individual
Prefix:MS
First Name:KATHRYN
Middle Name:DENISE
Last Name:COOK
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9600 VETERANS DRIVE
Mailing Address - Street 2:MAILSTOP A123-GOLD-SW
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98493
Mailing Address - Country:US
Mailing Address - Phone:253-583-3706
Mailing Address - Fax:
Practice Address - Street 1:9600 VETERANS DRIVE
Practice Address - Street 2:MAILSTOP A123-GOLD-SW
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98493
Practice Address - Country:US
Practice Address - Phone:253-583-3706
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-25
Last Update Date:2015-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW 603761671041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical