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General NPI Number Information
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NPI Number | 1871907519
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Entity Type | Individual
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Provider Name | ANNE B CORLEY MS, RD, CD
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Gender | Female
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Dates
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Enumeration Date | 06/19/2014
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Last Update Date | 04/16/2021
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Provider Practice Location Address
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Address Line | 2202 SOUTH CEDAR ST #300/#200
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City | TACOMA
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State | WA
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Zip | 98405
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Country | US
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Telephone | 253-301-5280
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Fax |
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Provider Business Mailing Address
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Address Line | P.O. BOX 5299 MS: 737-3-PCON
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City | TACOMA
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State | WA
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Zip | 98415-0299
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | DI00001216
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License Number State | WA
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