Provider Demographics
NPI:1013316876
Name:CORRIGAN, JOANNE (RD, CD)
Entity Type:Individual
Prefix:MRS
First Name:JOANNE
Middle Name:
Last Name:CORRIGAN
Suffix:
Gender:F
Credentials:RD, CD
Other - Prefix:
Other - First Name:JOANNE
Other - Middle Name:
Other - Last Name:WOLLSTEIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD, CD
Mailing Address - Street 1:13033 BEL RED RD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98005-2633
Mailing Address - Country:US
Mailing Address - Phone:360-789-3873
Mailing Address - Fax:
Practice Address - Street 1:13033 BEL RED RD
Practice Address - Street 2:SUITE 210
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98005-2633
Practice Address - Country:US
Practice Address - Phone:360-789-3873
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-18
Last Update Date:2014-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1053280133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered