Provider Demographics
NPI:1821876863
Name:COOK, CHARLES KIRKPATRICK (MSN, BSN, RN)
Entity Type:Individual
Prefix:
First Name:CHARLES
Middle Name:KIRKPATRICK
Last Name:COOK
Suffix:
Gender:M
Credentials:MSN, BSN, RN
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Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:14862 SW 109TH AVE
Mailing Address - Street 2:
Mailing Address - City:TIGARD
Mailing Address - State:OR
Mailing Address - Zip Code:97224-3664
Mailing Address - Country:US
Mailing Address - Phone:502-876-2451
Mailing Address - Fax:
Practice Address - Street 1:4400 NE HALSEY ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97213-1545
Practice Address - Country:US
Practice Address - Phone:503-216-1200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-20
Last Update Date:2023-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246Y00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Health Information