# CORBIN D TUDOR

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1538210711
- **Gender:** Man
- **Credential:** PAC

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363A00000X | Physician Assistant | PA10004072 | WA | Yes |

## Other

- **Enumeration date:** 01/15/2007
- **Last updated:** 03/24/2015

## 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 |