Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VG0400X | Gynecologist | MD22869 | OR |
NPI | 1083761175 |
---|---|
Provider Name | Christine Marie Corbin |
First Address | Hillsboro, OR 97123 |
Second Address | Hillsboro, OR 97124 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/01/2007 |
Last Update Date | 15/01/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
287796 | (05) | OR |
F92209 | (02) |