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Individual
CORBIN D TUDOR
Active
Individual
CORBIN D TUDOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PAC
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA10004072
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0039594
LABOR AND INDUSTRIES #
WA
01
—
2541TU
BLUE SHIELD #
WA
05
—
8329260
—
WA
01
—
970021752
RAILROAD MC#
WA
01
—
US2439370
AETNA SPECIALIST PIN
WA
Enumeration date
01/15/2007
Last updated
03/24/2015
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