Healthcare Provider Details

I. General information

NPI: 1285312652
Provider Name (Legal Business Name): CORINNE HONEY RICHEY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CORINNE HONEY QUERREY

II. Dates (important events)

Enumeration Date: 07/06/2023
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

315 MARTIN LUTHER KING JR WAY
TACOMA WA
98405
US

IV. Provider business mailing address

PO BOX 5299 MS: 820-5-PCO
TACOMA WA
98415-0299
US

V. Phone/Fax

Practice location:
  • Phone: 253-403-1418
  • Fax: 253-403-5955
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA.PA.70094479
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number6324
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: