Cooke Therapy PLLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

COOKE THERAPY PLLC

Practice address

1125 SE Madison St Ste 102
Portland, OR 97214-3600

Phone

(503) 847-5473

Fax

(503) 925-5232

NPI assigned

Mar 28, 2019

Organization subpart

No

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

Authorized official

Name

Cheryl Lynne Cooke, PHD, DNP, PMHNP-BC

Title

Sole MBR

Phone

(503) 847-5473

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

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

{
    "created_epoch": "1553731200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1564704000000",
    "number": "1548721871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1125 SE MADISON ST STE 102",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972143600",
            "telephone_number": "503-847-5473",
            "fax_number": "503-925-5232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1125 SE MADISON ST STE 102",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972143600",
            "telephone_number": "503-847-5473",
            "fax_number": "503-925-5232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COOKE THERAPY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-28",
        "last_updated": "2019-08-02",
        "status": "A",
        "authorized_official_last_name": "COOKE",
        "authorized_official_first_name": "CHERYL",
        "authorized_official_middle_name": "LYNNE",
        "authorized_official_title_or_position": "SOLE MBR",
        "authorized_official_telephone_number": "503-847-5473",
        "authorized_official_credential": "PHD, DNP, PMHNP-BC"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500748734",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Medicaid",
            "affiliation": "N",
            "endpointDescription": "Medicaid Number",
            "address_1": "1125 SE Madison St Ste 102",
            "city": "Portland",
            "state": "OR",
            "country_code": "US",
            "postal_code": "972143600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Sara Cook
• Sari Natsu Matisoff Cook, PMHNP
• Susan Cook
• Susan E Cook, CNM
• Ted Allen Cook, MD
• Cristi Rae Cooke
• Harriet Cooke, M.D.
• Krystle Cooke
• Willoughby Francis Cooke, LMT,BCSI
• Charles Cookman

• Psychiatric/Mental Health Nurse Practitioner in Portland, OR
• Providers in Portland, OR by specialty
• Psychiatric/Mental Health Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2019; 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.