# CORA E KROUSE

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

## Provider details

- **NPI number:** 1891768560
- **Gender:** F
- **Credential:** PA-C

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363A00000X | Physician Assistant | PA10003891 | WA | Yes |
| 363AM0700X | Medical Physician Assistant | PA10003891 | WA | — |

## Other

- **Enumeration date:** 02/10/2006
- **Last updated:** 12/07/2020

## 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 |