Heather Alison Cook, LMT – Specialist in Gresham, OR

Key facts

NPI: 1770955262
Entity type: Individual (NPI type 1)
Primary specialty: Specialist 174400000X
License: 20464 (OR)
Practice address: 223 E Powell Blvd
Gresham, OR 97030-7605
Phone: (503) 667-1500
NPI assigned: Oct 23, 2015
Sex: Female
Sole proprietor: No

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD): No

State licenses

License	State	Type	Specialty
20464	OR	MD	Specialist

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Specialist	174400000X	20464	OR	Yes

Addresses

Primary practice location

223 E Powell Blvd
Gresham, OR 97030-7605

Mailing address

14385 SE Lusted Rd
Sandy, OR 97055-7551
Phone (575) 312-9391

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Oct 23, 2015.

{
    "created_epoch": "1445558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445558400000",
    "number": "1770955262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14385 SE LUSTED RD",
            "city": "SANDY",
            "state": "OR",
            "postal_code": "970557551",
            "telephone_number": "575-312-9391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "223 E POWELL BLVD",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970307605",
            "telephone_number": "503-667-1500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOK",
        "first_name": "HEATHER",
        "middle_name": "ALISON",
        "credential": "LMT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-23",
        "last_updated": "2015-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "OR",
            "license": "20464",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gresham, OR

All providers in Gresham, OR · Specialist in Oregon

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 23, 2015. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.