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Individual
CORA E KROUSE
Active
Individual
CORA E KROUSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA10003891
WA
363AM0700X
Medical Physician Assistant
PA10003891
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0238873
STATE L&I
WA
01
—
0273766
STATE L&I
WA
01
—
0302690
STATE L&I
WA
05
—
1021533
—
WA
05
—
8327124
—
WA
01
—
PA10003891
WA LICENSE
WA
Enumeration date
02/10/2006
Last updated
12/07/2020
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