Provider Demographics
NPI:1851781090
Name:MORIN, CORINA
Entity Type:Individual
Prefix:
First Name:CORINA
Middle Name:
Last Name:MORIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15220 SE 272ND ST
Mailing Address - Street 2:STE. D
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98042-4241
Mailing Address - Country:US
Mailing Address - Phone:253-217-0650
Mailing Address - Fax:
Practice Address - Street 1:15220 SE 272ND ST
Practice Address - Street 2:STE. D
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98042-4241
Practice Address - Country:US
Practice Address - Phone:253-217-0650
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-26
Last Update Date:2015-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA 60303728225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist