Healthcare Provider Details

I. General information

NPI: 1588539803
Provider Name (Legal Business Name): ERIC PAUL COCKE RRT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/07/2025
Last Update Date: 10/07/2025
Certification Date: 10/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9280 SE SUNNYBROOK BLVD STE 300
CLACKAMAS OR
97015-9353
US

IV. Provider business mailing address

3809 N ATTU ST
PORTLAND OR
97217-7401
US

V. Phone/Fax

Practice location:
  • Phone: 503-233-5548
  • Fax:
Mailing address:
  • Phone: 503-933-6576
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2279G1100X
TaxonomyGeneral Care Registered Respiratory Therapist
License NumberRT-P-10235757
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: