Individual
ROBERT W. CORLISS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5814 GRAHAM AVE, SUITE 100, SUMNER, WA 98390-2728
(253) 863-4474
(253) 863-4062
Mailing address
5814 GRAHAM AVE, SUITE 100, SUMNER, WA 98390-2728
(253) 863-4474
(253) 863-4062
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD00032451
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
101904
DEPT OF LABOR AND INDUST
WA
05
—
1094093
—
WA
01
—
110202913
RAILROAD MEDICARE
WA
Enumeration date
10/03/2006
Last updated
04/11/2012
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