Healthcare Provider Details

I. General information

NPI: 1518272210
Provider Name (Legal Business Name): JESSIE BROOK COOK PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JESSIE BROOK SASS

II. Dates (important events)

Enumeration Date: 08/18/2010
Last Update Date: 05/28/2020
Certification Date: 05/28/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 W MISSION AVE
SPOKANE WA
99201-2358
US

IV. Provider business mailing address

120 W MISSION AVE
SPOKANE WA
99201-2358
US

V. Phone/Fax

Practice location:
  • Phone: 509-326-4343
  • Fax: 509-329-2280
Mailing address:
  • Phone: 509-326-4343
  • Fax: 509-329-2280

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH60806375
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: