Provider Demographics
NPI:1598992695
Name:COSSEY, KORI NOELLE (DO)
Entity Type:Individual
Prefix:
First Name:KORI
Middle Name:NOELLE
Last Name:COSSEY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1567 HIGHLANDS DR NE
Mailing Address - Street 2:110-35
Mailing Address - City:ISSAQUAH
Mailing Address - State:WA
Mailing Address - Zip Code:98029-6245
Mailing Address - Country:US
Mailing Address - Phone:425-394-0610
Mailing Address - Fax:
Practice Address - Street 1:1567 HIGHLANDS DR NE
Practice Address - Street 2:110-35
Practice Address - City:ISSAQUAH
Practice Address - State:WA
Practice Address - Zip Code:98029-6245
Practice Address - Country:US
Practice Address - Phone:425-394-0610
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-16
Last Update Date:2016-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOP60281343207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine