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General NPI Number Information
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NPI Number | 1427905355
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Entity Type | Individual
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Provider Name | SHANDA B COOK
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Gender | Female
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Dates
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Enumeration Date | 03/11/2026
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Last Update Date | 03/11/2026
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Provider Practice Location Address
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Address Line | 389 SW SCALEHOUSE CT STE 130
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City | BEND
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State | OR
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Zip | 97702-3241
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Country | US
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Telephone | 541-306-4446
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Fax |
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Provider Business Mailing Address
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Address Line | 69 SE PIPER DR
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City | BEND
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State | OR
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Zip | 97702-1514
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Country | US
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Telephone | 541-728-7882
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Fax |
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State | OR
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