=====================================================
General NPI Number Information
=====================================================
NPI Number | 1770067613
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | LINDSAY ANN CORSA ARNP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/17/2018
-----------------------------------------------------
Last Update Date | 03/10/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1617 GROVE ST
-----------------------------------------------------
City | MARYSVILLE
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98270-4301
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 877-522-1275
-----------------------------------------------------
Fax | 833-888-7145
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 500 SW 7TH ST STE A205
-----------------------------------------------------
City | RENTON
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98057-2983
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 912-220-2390
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | AP60878823
-----------------------------------------------------
License Number State | WA
-----------------------------------------------------