Healthcare Provider Details

I. General information

NPI: 1447570460
Provider Name (Legal Business Name): CORAZON ESPINA ERICKSON ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/02/2010
Last Update Date: 06/02/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1959 NE PACIFIC ST BOX 356155
SEATTLE WA
98195-6155
US

IV. Provider business mailing address

1959 NE PACIFIC ST BOX 356155
SEATTLE WA
98195-6155
US

V. Phone/Fax

Practice location:
  • Phone: 206-598-9271
  • Fax: 206-598-6576
Mailing address:
  • Phone: 206-598-9271
  • Fax: 206-598-6576

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAP60001348
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN00138515
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: