Individual provider Active NPI

Clint Cook

  • Pharmacist
  • Spokane, WA
National Provider Identifier
1386940914
Registry record updated Nov 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
17736 Issued in WA
Practice address
12020 N Newport Hwy
Spokane, WA 99218-1655
Phone
(509) 466-3315
Fax
(509) 468-9101
NPI assigned
Jan 29, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 24, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 17736 WA Primary
Pharmacist 183500000X 43987 CA

Addresses

Primary practice location

12020 N Newport Hwy
Spokane, WA 99218-1655

Mailing address

2100 Dr Martin Luther King Junior Pkwy
Chico, CA 95928-4422
Phone (530) 342-8892

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
43987CAMDGeneral Practice Dentistry
17736WAMDPharmacist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1296259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606176000000",
    "number": "1386940914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 DR MARTIN LUTHER KING JUNIOR PKWY",
            "city": "CHICO",
            "state": "CA",
            "postal_code": "959284422",
            "telephone_number": "530-342-8892",
            "fax_number": "530-342-3658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12020 N NEWPORT HWY",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992181655",
            "telephone_number": "509-466-3315",
            "fax_number": "509-468-9101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOK",
        "first_name": "CLINT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-01-29",
        "last_updated": "2020-11-24",
        "certification_date": "2020-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WA",
            "license": "17736",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "43987",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.