Provider Demographics
NPI:1376696039
Name:DOODY, EMMA CORBILLA (ND)
Entity type:Individual
Prefix:
First Name:EMMA
Middle Name:CORBILLA
Last Name:DOODY
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:EMMA
Other - Middle Name:GALANG
Other - Last Name:CORBILLA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ND
Mailing Address - Street 1:190 W DAYTON ST STE 204
Mailing Address - Street 2:
Mailing Address - City:EDMONDS
Mailing Address - State:WA
Mailing Address - Zip Code:98020-7221
Mailing Address - Country:US
Mailing Address - Phone:206-880-1407
Mailing Address - Fax:
Practice Address - Street 1:190 W DAYTON ST STE 204
Practice Address - Street 2:
Practice Address - City:EDMONDS
Practice Address - State:WA
Practice Address - Zip Code:98020-7221
Practice Address - Country:US
Practice Address - Phone:206-880-1407
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-18
Last Update Date:2025-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANT00001546207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine