Individual
MS. CORIANDER KATHRYN HERIDIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
12844 MILITARY RD S, TUKWILA, WA 98168-3045
(253) 324-5005
Mailing address
417 104TH AVE E, EDGEWOOD, WA 98372-6011
(253) 324-5005
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
9208153
FL
363LF0000X
Family Nurse Practitioner
Primary
ARNP.AP.60265319-NP
WA
363LF0000X
Family Nurse Practitioner
ARNP9208153
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001157200
—
FL
01
—
Y00KX
BCBS
FL
Enumeration date
11/25/2005
Last updated
03/08/2013
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