Individual
MRS. CORALEE RUTH KONING
Active
Individual
MRS. CORALEE RUTH KONING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA153205
OR
363A00000X
Physician Assistant
PA60188369
WA
363AM0700X
Medical Physician Assistant
Primary
PA14217
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500655889
—
OR
01
—
P01238392
RAILROAD MEDICARE - PHS - WA
WA
Enumeration date
10/07/2005
Last updated
09/14/2021
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