Individual
CORALYNN SHAYNA SACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
240828
MA
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
MD60343580
WA
207RP1001X
Pulmonary Disease Physician
Primary
MD60343580
WA
Other
Enumeration date
06/17/2009
Last updated
03/17/2018
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