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General NPI Number Information
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NPI Number | 1942546387
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Entity Type | Individual
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Provider Name | ANGELA S CORSETTO LMP
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Gender | Female
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Dates
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Enumeration Date | 12/12/2012
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Last Update Date | 12/12/2012
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Provider Practice Location Address
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Address Line | 9716 NE JUANITA DR
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City | KIRKLAND
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State | WA
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Zip | 98034-4202
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Country | US
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Telephone | 425-823-5333
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Fax |
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Provider Business Mailing Address
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Address Line | 7054 123RD AVE SE
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City | NEWCASTLE
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State | WA
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Zip | 98056-1215
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Country | US
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Telephone | 425-829-0552
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | MA00018647
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License Number State | WA
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