| Dr. Thomas Cooke | |
|
1217 Mellen St Centralia WA 98531-1175 | |
| (360) 736-4021 | |
| (360) 736-3541 |
| Full Name | Dr. Thomas Cooke |
|---|---|
| Speciality | Family Medicine |
| Location | 1217 Mellen St, Centralia, Washington |
| Authorized Official Name and Position | Thomas R Cooke (DOCTOR) |
| Authorized Official Contact | 3607364021 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr. Thomas Cooke 1217 Mellen St Centralia WA 98531-1175 Ph: (360) 736-4021 | Dr. Thomas Cooke 1217 Mellen St Centralia WA 98531-1175 Ph: (360) 736-4021 |
| NPI Number | 1194908368 |
|---|---|
| Provider Enumeration Date | 12/11/2007 |
| Last Update Date | 01/10/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194908368 | NPI | - | NPPES |
| 7053861 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | OP00000823 (Washington) | Primary |
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