Provider Demographics
NPI:1821056532
Name:COOK, PRICE MARTIN (LMFT)
Entity Type:Individual
Prefix:MR
First Name:PRICE
Middle Name:MARTIN
Last Name:COOK
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:MR
Other - First Name:PRICE
Other - Middle Name:
Other - Last Name:COOK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMFT
Mailing Address - Street 1:7304 10TH ST SE STE B201
Mailing Address - Street 2:
Mailing Address - City:LAKE STEVENS
Mailing Address - State:WA
Mailing Address - Zip Code:98258-3690
Mailing Address - Country:US
Mailing Address - Phone:425-286-7291
Mailing Address - Fax:
Practice Address - Street 1:7304 10TH ST SE STE B201
Practice Address - Street 2:
Practice Address - City:LAKE STEVENS
Practice Address - State:WA
Practice Address - Zip Code:98258-3690
Practice Address - Country:US
Practice Address - Phone:425-286-7291
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-02
Last Update Date:2021-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALF00001325106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA186178OtherMHN
WA2448COOtherREGENCE BLUE SHIELD