Provider Demographics
NPI:1568917029
Name:COREY, LINDA (ARNP)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:
Last Name:COREY
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14604 35TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:LAKE FOREST PARK
Mailing Address - State:WA
Mailing Address - Zip Code:98155-7823
Mailing Address - Country:US
Mailing Address - Phone:206-566-3845
Mailing Address - Fax:206-267-0704
Practice Address - Street 1:14604 35TH AVE NE
Practice Address - Street 2:
Practice Address - City:LAKE FOREST PARK
Practice Address - State:WA
Practice Address - Zip Code:98155-7823
Practice Address - Country:US
Practice Address - Phone:206-566-3845
Practice Address - Fax:206-267-0704
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-24
Last Update Date:2020-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60691167363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health