Individual
JOHN JOSEPH CORRALES-DIAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
19245 7TH AVE NE, POULSBO, WA 98370-6551
(360) 782-3500
(360) 782-3540
Mailing address
19245 7TH AVE NE, POULSBO, WA 98370-6551
(360) 782-3500
(360) 782-3540
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD00021573
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1000428
—
WA
01
—
4586742
AETNA
—
01
—
CO7915
REGENCE BLUE SHIELD
—
Enumeration date
05/12/2006
Last updated
03/06/2023
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