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NPI Code Detail

MEDICARE: PETER KORIN MSW

MEDICARE: PETER KORIN MSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health CounselorRC00051120WA

General Provider Information

NPI Number : 1447430327
Entity Type Code : Individual
Provider Name (Legal Business Name) : PETER KORIN MSW
Provider Business Mailing Address
First Line : 1911 SW CAMPUS DR STE 123
Second Line :
City : FEDERAL WAY
State : WA
Zip : 98023-6473
Country : US
Telephone Number : 253-396-5800
Fax Number : 253-759-1008
Provider Business Practice Location Address
First Line : 1201 S PROCTOR ST
Second Line :
City : TACOMA
State : WA
Zip : 98405-2047
Country : US
Telephone Number : 253-396-5800
Fax Number : 253-759-7008
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/08/2007
Last Update Date : 11/08/2007

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Directions to “ PETER KORIN MSW” Practice Location

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