Healthcare Provider Details

I. General information

NPI: 1548632532
Provider Name (Legal Business Name): NORTHWEST INTEGRATIVE MEDICINE, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/29/2015
Last Update Date: 12/22/2025
Certification Date: 12/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15875 SW 72ND AVE
TIGARD OR
97224-7913
US

IV. Provider business mailing address

15875 SW 72ND AVE
TIGARD OR
97224-7913
US

V. Phone/Fax

Practice location:
  • Phone: 503-855-4341
  • Fax: 833-955-3574
Mailing address:
  • Phone: 503-855-4341
  • Fax: 833-955-3574

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number3005
License Number StateOR

VIII. Authorized Official

Name: DR. MAEGHAN CULVER COOK
Title or Position: PRESIDENT
Credential: N.D.
Phone: 503-855-4341