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General NPI Number Information
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NPI Number | 1194745729
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Entity Type | Individual
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Provider Name | DANA ANTHONY COCKE OD
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Gender | Male
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Dates
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Enumeration Date | 07/19/2006
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Last Update Date | 01/24/2008
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Provider Practice Location Address
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Address Line | 5003 TACOMA MALL BLVD STE 102
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City | TACOMA
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State | WA
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Zip | 98409-7120
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Country | US
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Telephone | 253-472-5813
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Fax | 253-472-0640
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Provider Business Mailing Address
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Address Line | 5003 TACOMA MALL BLVD STE 102
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City | TACOMA
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State | WA
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Zip | 98409-7120
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Country | US
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Telephone | 253-472-5813
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Fax | 253-472-0640
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152WC0802X
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Taxonomy Name | Corneal and Contact Management Optometrist
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License Number | 3140
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License Number State | WA
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