Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | MD60588296 | WA |
Y | 111NI0900X | Internist | MD60588296 | WA |
NPI | 1003159013 |
---|---|
Provider Name | Dr. Maria Ann Corcorran |
First Address | Seattle, WA 98145-5095 |
Second Address | Seattle, WA 98133-8401 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/03/2013 |
Last Update Date | 12/05/2020 |