Provider Demographics
NPI:1922388750
Name:COOK, ERIN L (PSYD)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:L
Last Name:COOK
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:LEIGH
Other - Last Name:MCCUTCHEON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1130 SW MORRISON ST STE 619
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97205-2217
Mailing Address - Country:US
Mailing Address - Phone:719-200-5635
Mailing Address - Fax:
Practice Address - Street 1:5 CENTERPOINTE DR STE 320
Practice Address - Street 2:
Practice Address - City:LAKE OSWEGO
Practice Address - State:OR
Practice Address - Zip Code:97035-8696
Practice Address - Country:US
Practice Address - Phone:971-200-5635
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-24
Last Update Date:2024-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR3024103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical