Provider Demographics
NPI:1992839195
Name:BARTOS, CORINNA (MD)
Entity type:Individual
Prefix:DR
First Name:CORINNA
Middle Name:
Last Name:BARTOS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:CORINNA
Other - Middle Name:
Other - Last Name:AVALOS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:9040 JACKSON AVE
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98431-0001
Mailing Address - Country:US
Mailing Address - Phone:253-968-2926
Mailing Address - Fax:253-968-6261
Practice Address - Street 1:9040 JACKSON AVE
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98431-5285
Practice Address - Country:US
Practice Address - Phone:539-682-9262
Practice Address - Fax:253-968-6261
Is Sole Proprietor?:No
Enumeration Date:2007-03-16
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61380078207R00000X
VA0101253750207R00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine