Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | MD00047207 | WA |
Y | 2084N0402X | Child Neurologist | MD00047207 | WA |
NPI | 1265522791 |
---|---|
Provider Name | Vera A Korol |
First Address | Tacoma, WA 98415-0299 |
Second Address | Tacoma, WA 98405-4234 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/10/2006 |
Last Update Date | 24/10/2019 |