Individual
MR. TANA LOUISE CORNELIUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RRT
Contact information
Practice address
1143 NIMITZ DR, COUPEVILLE, WA 98239
(949) 463-5487
Mailing address
1143 NIMITZ DR, COUPEVILLE, WA 98239
(949) 463-5487
Taxonomy
Speciality
Code
Description
License number
State
2279G1100X
General Care Registered Respiratory Therapist
00025245
CA
2279G1100X
General Care Registered Respiratory Therapist
Primary
LR 00003883
WA
Other
Enumeration date
01/23/2009
Last updated
01/23/2009
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