Terrill Cooke, Jacqualine M

Terrill Cooke, Jacqualine M is an individual health care provider with primary practice located at 320 Se Baker St , Mcminnville OR 97128-6038. She recently has 3 registered licenses in different health care specialties including Nursing Service Providers / General Practice, Physician Assistants & Advanced Practice Nursing Providers / Family, Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Terrill Cooke, Jacqualine M can be contacted via phone (503) 474-3600.

Contact Information

Primary practice address
320 Se Baker St Mcminnville OR 97128-6038
Phone: (503) 474-3600
Fax: (503) 474-3601
Website:
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Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / General Practice 163WG0000X 200040704RN Oregon
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 200350072NPFNPPP Oregon
Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife 367A00000X 200450066NP Oregon

Profile Details

NPI number 1285698555
LBN Legal business name Terrill Cooke, Jacqualine M
Credentials CNM FNP
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 13th, 2006
Last updated Aug 14th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1285698555 NPPES
Oregon MEDICAID 233427

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