Provider Demographics
NPI:1710634464
Name:COOK, TANELE M (ARNP)
Entity type:Individual
Prefix:
First Name:TANELE
Middle Name:M
Last Name:COOK
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:404 YAUGER WAY SW STE 100
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98502-8152
Mailing Address - Country:US
Mailing Address - Phone:564-669-5150
Mailing Address - Fax:564-669-5155
Practice Address - Street 1:404 YAUGER WAY SW STE 100
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98502-8152
Practice Address - Country:US
Practice Address - Phone:564-669-5150
Practice Address - Fax:564-669-5155
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-03
Last Update Date:2024-12-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAAP61272223363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health