Corcoran, Blake Cooper

Corcoran, Blake Cooper is an individual health care provider with primary practice located at 1125 Se Washington St. , Pullman WA 99164. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Sports Medicine. Allopathic & Osteopathic Physicians / Sports Medicine is his primary health care specialty. Corcoran, Blake Cooper can be contacted via phone (509) 335-3575.

Contact Information

Primary practice address
1125 Se Washington St. Pullman WA 99164
Phone: (509) 335-3575
Fax: (509) 335-6223
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X MD458625 Pennsylvania
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X MD600771757 Washington
Allopathic & Osteopathic Physicians / Sports Medicine 207QS0010X MD458625 Pennsylvania
Allopathic & Osteopathic Physicians / Sports Medicine 207QS0010X MD60771757 Washington

Profile Details

NPI number 1235490038
LBN Legal business name Corcoran, Blake Cooper
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 7th, 2012
Last updated Aug 14th, 2019 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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