Provider Demographics
NPI:1578245502
Name:HARTUNIAN, COREY C (RN61457849)
Entity Type:Individual
Prefix:
First Name:COREY
Middle Name:C
Last Name:HARTUNIAN
Suffix:
Gender:F
Credentials:RN61457849
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1314 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:SNOHOMISH
Mailing Address - State:WA
Mailing Address - Zip Code:98290-1814
Mailing Address - Country:US
Mailing Address - Phone:206-454-9769
Mailing Address - Fax:
Practice Address - Street 1:1314 PARK AVE
Practice Address - Street 2:
Practice Address - City:SNOHOMISH
Practice Address - State:WA
Practice Address - Zip Code:98290-1814
Practice Address - Country:US
Practice Address - Phone:206-454-9769
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-01
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN61457849163WX0003X, 163WM0102X, 163WH0200X, 163WN0003X, 163WP1700X, 163WW0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0102XNursing Service ProvidersRegistered NurseMaternal Newborn
No163WX0003XNursing Service ProvidersRegistered NurseObstetric, Inpatient
No163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163WN0003XNursing Service ProvidersRegistered NurseNeonatal, Low-Risk
No163WP1700XNursing Service ProvidersRegistered NursePerinatal
No163WW0101XNursing Service ProvidersRegistered NurseWomen's Health Care, Ambulatory