Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | PY00003560 | WA |
Y | 103TC0700X | Clinical Psychologist | PY00003560 | WA |
NPI | 1013012129 |
---|---|
Provider Name | Dr. Diana Lyn Cook |
First Address | Edmonds, WA 98026-7536 |
Second Address | Edmonds, WA 98026-7536 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/09/2006 |
Last Update Date | 08/07/2007 |