Corey D Carson (NPI# 1497254635, PAC ID# 8022379619) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICIAN ASSISTANT.
| Nation Provider ID (NPI) | 1497254635 |
| PAC ID by PECOS | 8022379619 |
| Professional Enrollment ID | I20180222000617 |
| Full Name | Corey D Carson |
| Organization Legal Name | PROVIDENCE HEALTH AND SERVICES - WASHINGTON |
| Address |
301 W Poplar St Walla Walla WA 99362-2800 |
| Gender | M |
| Graduation Year | 2017 |
| Primary Specialty | PHYSICIAN ASSISTANT |
| Group Practice PAC ID | 2860552973 |
| Number of Group Practice Members | 162 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 500002 | PROVIDENCE ST MARY MEDICAL CENTER |
| 381319 | ST ANTHONY HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 301 W Poplar St, Walla Walla, WA 99362-2800 | PROVIDENCE HEALTH AND SERVICES - WASHINGTON | |
| 380 Chase Ave, Walla Walla, WA 99362-2924 | 5098973333 | PROVIDENCE HEALTH AND SERVICES - WASHINGTON |
| Organization Legal Name | PROVIDENCE HEALTH AND SERVICES - WASHINGTON |
| Physicians | 212 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Holly Ross Farnam | Physical Therapy | Providence Health and Services - Washington | 1111 S 2nd Ave, Walla Wall, WA 99362-4118 |
| Andrew Meillier | Hospitalist | Providence Health and Services - Washington | 401 W Poplar St, Walla Walla, WA 99362-2846 |
| Johanna Menard | Nurse Practitioner | Providence Health and Services - Washington | 1705 Se Meadowbrook Blvd, Suite 2, College Place, WA 99324-1756 |
| Kortney K Killgore Smith | Nurse Practitioner | Providence Health and Services - Washington | 1025 S 2nd Ave, Walla Walla, WA 99362-4116 |
| Brianne N Bridgeland | Nurse Practitioner | Providence Health and Services - Washington | 380 Chase Ave, Walla Walla, WA 99362-2924 |
| Gordon G Hoffnagle | Certified Registered Nurse Anesthetist (crna) | Providence Health and Services - Washington | 982 E Columbia Ave, Colville, WA 99114-3316 |
| Julie M Rice | Nurse Practitioner | Providence Health and Services - Washington | 18313 Paulson St Sw, Suite A, Rochester, WA 98579-9262 |
| Charles E Nussbaum | Neurosurgery | Providence Health and Services - Washington | 301 W Poplar St, Suite 50, Walla Walla, WA 99362-2800 |
| Adam D Ostrowski | Occupational Therapy | Providence Health and Services - Washington | 1025 S 2nd Ave, Walla Walla, WA 99362-4116 |
| Julie Ann Cooke | Qualified Speech Language Pathologist | Providence Health and Services - Washington | 1111 S 2nd Ave, Walla Wall, WA 99362-4118 |
| Street Address |
301 W POPLAR ST |
| City | WALLA WALLA |
| State | WA |
| Zip | 99362-2800 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Charles E Nussbaum | Neurosurgery | Providence Health and Services - Washington | 301 W Poplar St, Suite 50, Walla Walla, WA 99362-2800 |
| Joel Quiroz | Physician Assistant | Providence Health and Services - Washington | 301 W Poplar St, Walla Walla, WA 99362-2800 |
| Glyn E A Marsh | Physical Medicine and Rehabilitation | Providence Health and Services - Washington | 301 W Poplar St, Suite 50, Walla Walla, WA 99362-2800 |
| Ali J Naini | Neurosurgery | Providence Health and Services - Washington | 301 W Poplar St, Suite 50, Walla Walla, WA 99362-2800 |
| Derek E Sucharda | Physician Assistant | Providence Health and Services - Washington | 301 W Poplar St, Walla Walla, WA 99362-2800 |
| Chelane R Fackenthall | Nurse Practitioner | Providence Health and Services - Washington | 301 W Poplar St, Suite 50, Walla Walla, WA 99362-2800 |
| Julie N Butcher | Physician Assistant | Providence Health and Services - Washington | 301 W Poplar St, Walla Walla, WA 99362-2800 |
| Stacey Bogdanowicz | Physician Assistant | Providence Health and Services - Washington | 301 W Poplar St, Walla Walla, WA 99362-2800 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Cynthia A Wallace | Clinical Social Worker | 19 E Birch, Suite 103, Walla Walla, WA 99362 | |
| Susan L Stough | Clinical Social Worker | 409 E Sumach St, Suite 6, Walla Walla, WA 99362-1202 | |
| Natasha Anne Rustad | Clinical Social Worker | 409 E Sumach St, Rustad Counseling LLC, Walla Walla, WA 99362-1202 | |
| Pavel S Blagov | Clinical Psychologist | 409 E Sumach St, Suite 3, Walla Walla, WA 99362-1202 | |
| Robert L Stough Jr. | Psychologist, Clinical | 409 E Sumach St, Walla Walla, WA 99362-1228 | |
| Chance Higginbotham | Chiropractic | 2200 Melrose St, 7a, Walla Walla, WA 99362-1579 | |
| Alayna M Brinton | Clinical Social Worker | 2330 Eastgate St, Suite 140, Walla Walla, WA 99362-1589 | |
| Sean Thomas Duffy | Family Medicine | Yakima Valley Farm Workers Clinic | 1120 W Rose St, Walla Walla, WA 99362-1662 |
| Bradley K Nielson | Optometry | 208 N 2nd Ave, Walla Walla, WA 99362-1806 | |
| Eric John Wiessner | Optometry | 614 E Alder St, Suite 1, Walla Walla, WA 99362-2073 | |
| Find all physicians in zip 99362 | |||
| City | WALLA WALLA |
| Zip Code | 99362 |
| Specialty | PHYSICIAN ASSISTANT |
| City + Specialty | WALLA WALLA + PHYSICIAN ASSISTANT |
Please comment or provide details below to improve the information on Corey D Carson.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.