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General NPI Number Information
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NPI Number | 1497070486
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Entity Type | Individual
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Provider Name | MACKENZIE RAINIER COOK MD
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Gender | Male
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Dates
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Enumeration Date | 04/01/2010
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 3181 SW SAM JACKSON PARK ROAD OHSU
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City | PORTLAND
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State | OR
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Zip | 97239-2393
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Country | US
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Telephone | 503-494-5300
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Fax | 503-494-6519
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Provider Business Mailing Address
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Address Line | 3181 SW SAM JACKSON PARK RD MAIL CODE: L223
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City | PORTLAND
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State | OR
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Zip | 97239
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Country | US
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Telephone | 860-463-5727
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | MD184572
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 2086S0102X
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Taxonomy Name | Surgical Critical Care Physician
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License Number | MD184572
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License Number State | OR
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Taxonomy #3
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Taxonomy Code | 2086S0127X
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Taxonomy Name | Trauma Surgery Physician
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License Number | MD184572
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License Number State | OR
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