Provider Demographics
NPI:1780958272
Name:SNOOK, RICK QUINTON
Entity type:Individual
Prefix:
First Name:RICK
Middle Name:QUINTON
Last Name:SNOOK
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22000 WILLAMETTE DR
Mailing Address - Street 2:107
Mailing Address - City:WEST LINN
Mailing Address - State:OR
Mailing Address - Zip Code:97068-3275
Mailing Address - Country:US
Mailing Address - Phone:503-722-8888
Mailing Address - Fax:
Practice Address - Street 1:18005 SW FITCH DR
Practice Address - Street 2:
Practice Address - City:SHERWOOD
Practice Address - State:OR
Practice Address - Zip Code:97140-8860
Practice Address - Country:US
Practice Address - Phone:503-925-9237
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-29
Last Update Date:2012-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist