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Individual

CORBIN JAMES BROKAW

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
2409 N 45TH ST, SEATTLE, WA 98103-6907
(206) 633-8100
(206) 633-6107
Mailing address
2409 N 45TH ST, SEATTLE, WA 98103-6907
(206) 633-8100
(206) 633-6107

Taxonomy

Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA60899309
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2108733
WA
Enumeration date
09/25/2018
Last updated
10/25/2018
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