Individual
SANDRA L. CORLISS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
325 9TH AVE, SEATTLE, WA 98104-2499
(206) 731-3000
Mailing address
PO BOX 50095, SEATTLE, WA 98145-5095
(206) 543-6420
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
AP30007027
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0199741
L&I PIN
WA
05
—
1700830965
—
WA
01
—
46811U
REGENCE BLUE SHIELD PIN
WA
Enumeration date
05/20/2006
Last updated
12/11/2013
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