Provider Demographics
NPI:1184725400
Name:COOK, LOUIS HENRY (DC)
Entity type:Individual
Prefix:DR
First Name:LOUIS
Middle Name:HENRY
Last Name:COOK
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 SO 208TH ST
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:98198-2942
Mailing Address - Country:US
Mailing Address - Phone:206-878-7575
Mailing Address - Fax:206-824-2278
Practice Address - Street 1:105 S 208TH ST
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:WA
Practice Address - Zip Code:98198-2942
Practice Address - Country:US
Practice Address - Phone:206-878-7575
Practice Address - Fax:206-824-2278
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-26
Last Update Date:2019-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00000785111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA12496OtherL & I
WAC03252OtherREGENCE BLUE CROSS
WA2210201Medicaid
WA5937354OtherAETNA
WAG000101042Medicare ID - Type Unspecified