Provider Demographics
NPI:1073701454
Name:CORCORAN, HELEN G (PA-C)
Entity Type:Individual
Prefix:
First Name:HELEN
Middle Name:G
Last Name:CORCORAN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:16916 140TH AVE NE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:WOODINVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98072-6957
Mailing Address - Country:US
Mailing Address - Phone:425-481-6363
Mailing Address - Fax:425-488-4971
Practice Address - Street 1:17311 135TH AVE NE
Practice Address - Street 2:SUITE A700
Practice Address - City:WOODINVILLE
Practice Address - State:WA
Practice Address - Zip Code:98072
Practice Address - Country:US
Practice Address - Phone:425-488-4944
Practice Address - Fax:425-488-4942
Is Sole Proprietor?:No
Enumeration Date:2007-10-10
Last Update Date:2014-02-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WAPA10005273363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAPA10005273OtherSTATE LICENSE
WA8495848Medicaid
G8879145Medicare UPIN