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Individual

COREY ELIZABETH KOLLN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMT

Contact information

Practice address
451 SUNDANCE DR, RICHLAND, WA 99352-8625
(502) 849-8446
Mailing address
451 SUNDANCE DR, RICHLAND, WA 99352-8625
(502) 849-8446

Taxonomy

Speciality
Code
Description
License number
State
171W00000X
Contractor
11365
OR
225700000X
Massage Therapist
Primary
60955540
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
225700000X
WASHINGTON STATE DEPT OF HEALTH
WA
01
60955540
WASHINGTON STATE DEPT OF HEALTH
WA
Enumeration date
03/14/2007
Last updated
02/20/2020
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