Basic Information
Provider Information
NPI: 1568023984
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ZOOK
FirstName: PIERRE
MiddleName:  
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Credential:  
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Mailing Information
Address1: 16083 SW UPPER BOONES FERRY RD STE 300
Address2:  
City: TIGARD
State: OR
PostalCode: 972247736
CountryCode: US
TelephoneNumber: 5034436156
FaxNumber: 5036399699
Practice Location
Address1: 2191 NW 2ND ST BLDG 4
Address2:  
City: MCMINNVILLE
State: OR
PostalCode: 971289106
CountryCode: US
TelephoneNumber: 5034349594
FaxNumber: 5034346808
Other Information
ProviderEnumerationDate: 06/26/2019
LastUpdateDate: 06/26/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
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IsSoleProprietor: N
IsOrganizationSubpart:  
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AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000X63234ORY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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