Provider Demographics
NPI:1215291687
Name:CORIGLIANO, ANGIE
Entity type:Individual
Prefix:
First Name:ANGIE
Middle Name:
Last Name:CORIGLIANO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:907 W 14TH AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99204-3821
Mailing Address - Country:US
Mailing Address - Phone:509-624-2371
Mailing Address - Fax:
Practice Address - Street 1:907 W 14TH AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99204-3821
Practice Address - Country:US
Practice Address - Phone:509-624-2371
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-29
Last Update Date:2012-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH 00051604183500000X
CARPH 55170183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist