A smiling man with gray hair and beard outdoors in front of a green landscape.

Dr. Samuel Urkov

Doctor of Nursing Practice (DNP)

Family Nurse Practitioner (FNP-C)

Headache & Migraine Specialist

I get migraine disease.

I’ve lived with it for as long as I can remember. My first attacks started when I was five years old. At the time, it felt like senseless, purposeless pain that I couldn’t stop. My mom had migraines, my brother had them, even my grandparents suffered. It was woven into my family story — but I now understand how it would soon shape my future.

Through childhood, high school, and into college, I kept chasing answers. I thought I wanted to become a physician (a neurologist, specifically), and I cycled through nearly every medication for migraine prevention and acute relief. Nothing seemed to work. In fact, I was getting worse.

Everything changed the day I got double-booked at a prominent headache clinic and was asked if I’d be willing to see the nurse practitioner instead. She didn’t just throw another prescription at me. She sat with me, explained medication overuse headache (something I’d never heard of), and gave me the tools to understand what was happening in my own body. That conversation was a turning point. I walked out of that visit knowing I didn’t want to go to med school anymore. I wanted to become a nurse, and one day, a nurse practitioner who could help people with migraine the way she helped me.

For the next decade, I worked in hospitals around the country as an intensive care and surgical recovery room nurse. I cared for patients in extreme pain and learned firsthand the many ways pain shows up in the body, and how differently it needs to be treated in each person. During my doctoral training, at every opportunity I had, I tailored my education toward headache medicine, working in specialty clinics and learning from experts who dedicated their lives to this field.

Today, I practice full-time as a headache specialist at Puget Sound Neurology in Tacoma, Washington, while building Cascade Headache, a virtual-first hybrid clinic designed to expand access to specialty headache care across Washington and Oregon.

Why Cascade Headache?

I started Cascade Headache because I know what it feels like to live with migraine: the frustration, the isolation, the endless trial and error. And I also know how life-changing it can be to sit across from someone who truly understands, who listens, and who understands the struggle of chronic migraine disease.

How I Practice:

My approach blends evidence-based medicine with a holistic lens. Sometimes that means medication or procedures; other times it’s lifestyle strategies, mindfulness, or simply slowing down enough to notice what your body is communicating. Headache care isn’t one-size-fits-all; it’s a partnership that requires respect and trust.

At Cascade Headache, you won’t be just a number in a crowded clinic. You’ll be heard, respected, and supported as we build a plan together that fits your life, your values, and your goals.

Migraine is part of my story, too!
And helping you reclaim your life from it is the reason I do this work.