Provider Demographics
NPI:1740579119
Name:COOKE, LACHLAN ERIC (MAC, EAMP)
Entity Type:Individual
Prefix:MR
First Name:LACHLAN
Middle Name:ERIC
Last Name:COOKE
Suffix:
Gender:M
Credentials:MAC, EAMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 19543
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98109-1543
Mailing Address - Country:US
Mailing Address - Phone:206-369-5376
Mailing Address - Fax:
Practice Address - Street 1:700 WARREN AVE N
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98109-4027
Practice Address - Country:US
Practice Address - Phone:206-369-5376
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-06
Last Update Date:2011-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC60209968171100000X
HIACU964171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist