Provider Demographics
NPI:1073271219
Name:COREAS, GRISELDA (LMFT)
Entity type:Individual
Prefix:
First Name:GRISELDA
Middle Name:
Last Name:COREAS
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22547 NE ALDER CREST LN
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98053-5801
Mailing Address - Country:US
Mailing Address - Phone:832-503-0284
Mailing Address - Fax:
Practice Address - Street 1:22547 NE ALDER CREST LN
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98053-5801
Practice Address - Country:US
Practice Address - Phone:832-503-0284
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-06
Last Update Date:2025-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX204220106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist