Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NI0013X | Independent Medical Examiner | MA60483443 | WA |
NPI | 1790182517 |
---|---|
Provider Name | Korrin Beals |
First Address | Seattle, WA 98103-8017 |
Second Address | Seattle, WA 98103-8017 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/11/2014 |
Last Update Date | 21/11/2014 |