Healthcare Provider Details

I. General information

NPI: 1508610445
Provider Name (Legal Business Name): CORINNE ALYSSA AUSTIN FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CORINNE ALYSSA BARRON

II. Dates (important events)

Enumeration Date: 04/16/2024
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

507 N SULLIVAN RD STE 20
SPOKANE VALLEY WA
99037-8530
US

IV. Provider business mailing address

9918 N BLUFF VIEW DR
HAUSER ID
83854-6585
US

V. Phone/Fax

Practice location:
  • Phone: 434-282-4105
  • Fax:
Mailing address:
  • Phone: 434-282-4105
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP61537381
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: