Individual
TERRY SPARK CORWIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
MD00040591
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0160332
LABOR AND INDUSTRY
WA
01
—
340020074
RAILROAD MEDICARE
WA
05
—
8311342
—
WA
01
—
MD00040591
STATE LICENSE NUMBER
WA
Enumeration date
05/27/2006
Last updated
08/07/2024
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