COREY THACKER (NPI# 1235599234) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235599234 |
| Entity Type | Individual |
| Full Name | COREY THACKER |
| Practice Address |
1912 Nw Circle Dr N Poulsbo WA 98370-9527 |
| Practice Telephone | 4073259229 |
| Mailing Telephone | 4073259229 |
| Enumeration Date | 2016-03-03 |
| Last Update Date | 2016-03-03 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1710I1002X |
Military Health Care Provider Specialization: Independent Duty Corpsman |
Other Service Providers |
| Street Address |
1912 NW CIRCLE DR N |
| City | POULSBO |
| State | WA |
| Zip Code | 98370-9527 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790324010 | Francie Corinn Edens | Massage Therapist | 225 Nw Lindvig Way Suite# 6, Poulsbo, WA 98370 | 2020-01-03 |
| 1972155679 | Marcela Serocki | Massage Therapist | 18657 Wa-305, Suite 4, Poulsbo, WA 98370 | 2019-07-12 |
| 1508425943 | Ryan Brinton | Physical Therapist | Kitsap Physical Therapy and Sports Clinics, 19319 7th Ave Ne Ste 108, Poulsbo, WA 98370 | 2019-06-10 |
| 1598220816 | Naomi Whitney Orong | Massage Therapist | 19068 Nw Jenson Way, Suite 4b, Poulsbo, WA 98370 | 2019-02-01 |
| 1043774953 | Maryanne Phillips Bellman | Physical Therapist | 442 Viewmont Ave, Poulsbo, WA 98370 | 2019-01-24 |
| 1285102293 | Andrea Sander | Registered Nurse | 19883 12th Ave Ne, Poulsbo, WA 98370 | 2018-11-07 |
| 1376038281 | Sharon Renay Christor | Nurse Practitioner | 19160 Front St. Ne, Poulsbo, WA 98370 | 2018-06-25 |
| 1700304334 | Samantha Przybylek Gavinski | Nurse Practitioner | 19500 10th Ave Ne Suite 100, Poulsbo, WA 98370 | 2017-09-04 |
| 1285164327 | Johanna Taylor | Behavior Technician | 21786 Windmill Loop Nw, Poulsbo, WA 98370 | 2017-06-12 |
| 1568990554 | Eva Geurtsen | Physical Therapy Assistant | 19160 Front St, Poulsbo, WA 98370 | 2017-06-02 |
| Find all providers in zip 98370 | ||||
| Taxonomy Code | 1710I1002X |
| Grouping | Other Service Providers |
| Classification | Military Health Care Provider |
| Specialization | Independent Duty Corpsman |
| A Navy Independent Duty Corpsman (IDC) is an active duty Sailor who has successfully completed one of the Navy's specific IDC training programs. IDCs are formally trained and educated to perform primary medical care and minor surgical services in a variety of health care and non-health care settings worldwide under indirect physician supervision. IDCs provide care to Department of Defense operational forces and other supporting forces such as contractors and foreign nationals. |
| Notes: Source: Bureau of Medicine and Surgery, Department of the Navy [7/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669022810 | Shannon Dawkins | Military Health Care Provider | 2150 Thresher Ave, Silverdale, WA 98315-2103 | 2019-09-18 |
| 1669033098 | Crystal Belle Phipps Bloomfeldt | Military Health Care Provider | 214 Autumn Hills Rd, Kelso, WA 98626-9018 | 2019-06-26 |
| 1649830779 | Monica Yineman | Military Health Care Provider | 9812 Enchantment Ave Nw, Silverdale, WA 98383-8822 | 2019-06-20 |
| 1164992491 | Michael Thomas Stevens | Military Health Care Provider | 100 Hospital Loop, Fairchild Afb, WA 99011 | 2018-11-29 |
| 1326521097 | Elizabeth Nicole Sifuentes | Military Health Care Provider | Uss Michigan- Commander Sub Group Nine, 2150 Thresher Ave, Silverdale, WA 98315-2150 | 2018-09-10 |
| 1740710557 | Randle Scott Groves | Military Health Care Provider | Psns&imf Det Everett, 2000 West Marine Drive, Bldg 2202, Everett, WA 98207 | 2017-06-14 |
| 1679965222 | Asher Abbott White Jr. | Military Health Care Provider | 8806 86th Ave Nw, Gig Harbor, WA 98332-6752 | 2015-02-19 |
| 1023414927 | Larry Jones | Military Health Care Provider | 386 Nw Dory Dr, Oak Harbor, WA 98277-2077 | 2014-11-05 |
| 1598027237 | Epafara Jeffrey Vaitautolu | Military Health Care Provider | 30 Wencker Way Apt A, Bremerton, WA 98312-1861 | 2012-06-08 |
| 1841595352 | Brandon Alexander Martinfrazier | Military Health Care Provider | 610 Dowell St., Bldg. 6, Keyport, WA 98345 | 2011-01-13 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.