Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | 2976AT | OR |
N | 152WC0802X | Optomitrist - Corneal and Contact Lenses | 2976AT | OR |
NPI | 1326035544 |
---|---|
Provider Name | Dr. Rita Debbie Cook |
First Address | Beaverton, OR 97007-6194 |
Second Address | Beaverton, OR 97007-6194 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/10/2005 |
Last Update Date | 17/07/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
V00953 | (02) |