Provider Demographics
NPI:1760835896
Name:COREY, JILL (ND)
Entity Type:Individual
Prefix:
First Name:JILL
Middle Name:
Last Name:COREY
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:340 15TH AVE E STE 306
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98112-5156
Mailing Address - Country:US
Mailing Address - Phone:206-971-6708
Mailing Address - Fax:
Practice Address - Street 1:340 15TH AVE E STE 306
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98112-5156
Practice Address - Country:US
Practice Address - Phone:206-971-6708
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-13
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANT60618568175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath