Individual ProviderSamuel T CooperSocial WorkerBehavioral Health & Social Service ProvidersPractice Address3550 SE Woodward St, Portland, OR 97202-1552(503) 234-7532PECOS EnrollmentBased on the most recent information from CMS, provider Samuel T Cooper does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1013165950Provider TypeIndividualFull NameCooper, Samuel TTitleMr.GenderMaleSole ProprietorNoEnumeration Date9/4/2008Last Updated9/4/2008Contact InformationPractice LocationPractice Address3550 SE Woodward St, Portland, OR 97202-1552Phone(503) 234-7532FaxUnlisted FaxMailing LocationMailing Address3550 SE Woodward St, Portland, OR 97202-1552Phone(503) 234-7532FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode104100000XPrimaryDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicenseUnlisted Issuer