MEDICARE: CARA COOK ARNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LA2100X	Acute Care Nurse Practitioner	AP60525662	WA

General Provider Information

NPI Number	:	1568850154
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARA COOK ARNP

Provider Business Mailing Address
First Line	:	1504 NW 57TH ST
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98107-3017
Country	:	US
Telephone Number	:	406-581-6272
Fax Number	:

Provider Business Practice Location Address
First Line	:	1504 NW 57TH ST
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98107-3017
Country	:	US
Telephone Number	:	406-581-6272
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/05/2015
Last Update Date	:	01/05/2015

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