Provider Demographics
NPI:1073681946
Name:DEWING, KORI ANNE (DNP, ARNP)
Entity Type:Individual
Prefix:DR
First Name:KORI
Middle Name:ANNE
Last Name:DEWING
Suffix:
Gender:F
Credentials:DNP, ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 9TH AVENUE X6 RHE
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98101
Mailing Address - Country:US
Mailing Address - Phone:206-223-6824
Mailing Address - Fax:206-625-7288
Practice Address - Street 1:1100 9TH AVENUE X6 RHE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98101
Practice Address - Country:US
Practice Address - Phone:206-223-6824
Practice Address - Fax:206-625-7288
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30006596363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAG8875537OtherVMMC MEDICARE NUMBER
WAG8885839OtherVMMC WINSLOW MEDICARE PIN
Q08593Medicare UPIN