Provider Demographics
NPI:1386789808
Name:COOKE, JUDITH HILL (MA CS ARNP)
Entity type:Individual
Prefix:MS
First Name:JUDITH
Middle Name:HILL
Last Name:COOKE
Suffix:
Gender:F
Credentials:MA CS ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:903 E CREST RD
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99203-3550
Mailing Address - Country:US
Mailing Address - Phone:509-624-8164
Mailing Address - Fax:
Practice Address - Street 1:707 W 7TH AVE
Practice Address - Street 2:SUITE 240
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99204-2832
Practice Address - Country:US
Practice Address - Phone:509-624-8318
Practice Address - Fax:509-624-0609
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30003738364SP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8801162Medicare ID - Type UnspecifiedPSYCHIATRIC NURSE