Provider Demographics
NPI:1972326841
Name:CORRINA SKILDUM, PLLC
Entity type:Organization
Organization Name:CORRINA SKILDUM, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, MENTAL HEALTH COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:CORRINA
Authorized Official - Middle Name:
Authorized Official - Last Name:SKILDUM
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LMHC
Authorized Official - Phone:206-450-3741
Mailing Address - Street 1:10342 RAVENNA AVE NE
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98125-7744
Mailing Address - Country:US
Mailing Address - Phone:206-450-3741
Mailing Address - Fax:
Practice Address - Street 1:10342 RAVENNA AVE NE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98125-7744
Practice Address - Country:US
Practice Address - Phone:206-450-3741
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-07
Last Update Date:2024-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health