Provider Demographics
NPI:1447645098
Name:LINDBERG, CORINE
Entity type:Individual
Prefix:
First Name:CORINE
Middle Name:
Last Name:LINDBERG
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 1:231 E WHITMAN DR
Mailing Address - Street 2:
Mailing Address - City:COLLEGE PLACE
Mailing Address - State:WA
Mailing Address - Zip Code:99324-2133
Mailing Address - Country:US
Mailing Address - Phone:509-876-2100
Mailing Address - Fax:
Practice Address - Street 1:231 E WHITMAN DR
Practice Address - Street 2:
Practice Address - City:COLLEGE PLACE
Practice Address - State:WA
Practice Address - Zip Code:99324-2133
Practice Address - Country:US
Practice Address - Phone:509-876-2100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-31
Last Update Date:2015-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator