Individual
DR. CORIE LYNN SANDALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
9230 SKY ISLAND DR E, BONNEY LAKE, WA 98391-7385
(253) 750-6000
(253) 750-6100
Mailing address
9230 SKY ISLAND DR E, BONNEY LAKE, WA 98391-7385
(253) 750-6000
(253) 750-6100
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD00045674
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0210070
STATE L&I
WA
Enumeration date
01/17/2006
Last updated
08/04/2014
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