Provider Demographics
NPI:1710634464
Name:COOK, TANELE M (ARNP)
Entity Type:Individual
Prefix:
First Name:TANELE
Middle Name:M
Last Name:COOK
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1164 HIGHWAY 603
Mailing Address - Street 2:
Mailing Address - City:CHEHALIS
Mailing Address - State:WA
Mailing Address - Zip Code:98532-8917
Mailing Address - Country:US
Mailing Address - Phone:360-623-0122
Mailing Address - Fax:
Practice Address - Street 1:1164 HIGHWAY 603
Practice Address - Street 2:
Practice Address - City:CHEHALIS
Practice Address - State:WA
Practice Address - Zip Code:98532-8917
Practice Address - Country:US
Practice Address - Phone:360-623-0122
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-03
Last Update Date:2022-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP61272223363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health