Basic Information
| Provider Information | |||||||||
| NPI: | 1417982505 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | NAASZ | ||||||||
| FirstName: | CORRIE | ||||||||
| MiddleName: | A | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | SHEETS | ||||||||
| OtherFirstName: | CORRIE | ||||||||
| OtherMiddleName: | AINSLEE | ||||||||
| OtherNamePrefix: | |||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | |||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 6401 KIMBALL DR | ||||||||
| Address2: | |||||||||
| City: | GIG HARBOR | ||||||||
| State: | WA | ||||||||
| PostalCode: | 983351225 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2538589192 | ||||||||
| FaxNumber: | 2538584348 | ||||||||
| Practice Location | |||||||||
| Address1: | 6401 KIMBALL DR | ||||||||
| Address2: | |||||||||
| City: | GIG HARBOR | ||||||||
| State: | WA | ||||||||
| PostalCode: | 983351225 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2538589192 | ||||||||
| FaxNumber: | 2538584348 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/11/2006 | ||||||||
| LastUpdateDate: | 05/16/2011 | ||||||||
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| NPIReactivationDate: | |||||||||
| ProviderGenderCode: | F | ||||||||
| AuthorizedOfficialLastName: | |||||||||
| AuthorizedOfficialFirstName: | |||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | |||||||||
| AuthorizedOfficialTelephone: | |||||||||
| IsSoleProprietor: | N | ||||||||
| IsOrganizationSubpart: | |||||||||
| ParentOrganizationLBN: | |||||||||
| AuthorizedOfficialNamePrefix: | |||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | |||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | MD00041029 | WA | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 0159889 | 01 | WA | STATE L&I | OTHER | 0277657 | 01 | WA | L&I | OTHER | 8299158 | 05 | WA | MEDICAID | 0223267 | 01 | STATE L&I | OTHER | 0159891 | 01 | WA | STATE L&I | OTHER | 0159890 | 01 | WA | STATE L&I | OTHER | G8899864 | 01 | WA | MEDICARE | OTHER | 8936468 | 01 | WA | STATE CRIME VICTIMS | OTHER |