Mitchell, Cory

Mitchell, Cory is an individual health care provider with primary practice located at 1111 S 2Nd Ave , Walla Walla WA 99362. He recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Sports Medicine. Allopathic & Osteopathic Physicians / Sports Medicine is his primary health care specialty. Mitchell, Cory can be contacted via phone (509) 897-3700.

Contact Information

Primary practice address
1111 S 2Nd Ave Walla Walla WA 99362
Phone: (509) 897-3700
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Allopathic & Osteopathic Physicians / Sports Medicine 207QS0010X MD60878010 Washington

Profile Details

NPI number 1275943060
LBN Legal business name Mitchell, Cory
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date May 1st, 2014
Last updated Jun 18th, 2021 - about 4 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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Identifiers

StateTypeNumberIssuer
All States NPI 1275943060 NPPES
Washington MEDICAID 2106443

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