Individual
CORRIE L TAKAHASHI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
33501 1ST WAY S, MS: A-SO, FEDERAL WAY, WA 98003-6208
(253) 838-2400
(253) 874-1637
Mailing address
1100 9TH AVE, MS:M4-PFS, SEATTLE, WA 98101-2756
(206) 515-5811
(206) 515-5886
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD00046210
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0039577
LABOR AND INDUSTRIES#
WA
01
—
3867TA
BLUE SHIELD#
WA
05
—
8470445
—
WA
Enumeration date
09/20/2006
Last updated
08/27/2013
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