Provider Demographics
NPI:1336652981
Name:CORIGLIANO, TRACI M (PT, DPT)
Entity Type:Individual
Prefix:MRS
First Name:TRACI
Middle Name:M
Last Name:CORIGLIANO
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4228 E RICH AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99217-6765
Mailing Address - Country:US
Mailing Address - Phone:509-209-9488
Mailing Address - Fax:509-209-9489
Practice Address - Street 1:623 W GARLAND AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99205-2956
Practice Address - Country:US
Practice Address - Phone:509-209-9488
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-06
Last Update Date:2020-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT60792846225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAPT60792846OtherSTATE LICENSE